Provider Demographics
NPI:1467208249
Name:BAY AREA MHS LLC
Entity type:Organization
Organization Name:BAY AREA MHS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TUJNG
Authorized Official - Middle Name:THANH
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:408-655-7957
Mailing Address - Street 1:3775 BEACON AVE STE 233
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1468
Mailing Address - Country:US
Mailing Address - Phone:408-655-7957
Mailing Address - Fax:
Practice Address - Street 1:3775 BEACON AVE STE 233
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1468
Practice Address - Country:US
Practice Address - Phone:510-240-9322
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-24
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty