Provider Demographics
NPI:1659812147
Name:BILBREY, MALINDA A (MA)
Entity type:Individual
Prefix:MS
First Name:MALINDA
Middle Name:A
Last Name:BILBREY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MS
Other - First Name:MALINDA
Other - Middle Name:A
Other - Last Name:BILBREY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:1364 HILLCREST DR
Mailing Address - Street 2:
Mailing Address - City:MORRO BAY
Mailing Address - State:CA
Mailing Address - Zip Code:93442-1832
Mailing Address - Country:US
Mailing Address - Phone:310-221-6350
Mailing Address - Fax:
Practice Address - Street 1:1364 HILLCREST DR
Practice Address - Street 2:
Practice Address - City:MORRO BAY
Practice Address - State:CA
Practice Address - Zip Code:93442-1832
Practice Address - Country:US
Practice Address - Phone:310-221-6336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-16
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106555106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist