Provider Demographics
NPI:1720441678
Name:TAUS WELLNESS CENTER FOR MARRIAGE FAMILY THERAPY INC
Entity Type:Organization
Organization Name:TAUS WELLNESS CENTER FOR MARRIAGE FAMILY THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:TAUS
Authorized Official - Suffix:II
Authorized Official - Credentials:LMFT
Authorized Official - Phone:310-514-2300
Mailing Address - Street 1:1366 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:90732-3500
Mailing Address - Country:US
Mailing Address - Phone:310-514-2300
Mailing Address - Fax:310-548-0126
Practice Address - Street 1:1366 W 7TH ST
Practice Address - Street 2:
Practice Address - City:SAN PEDRO
Practice Address - State:CA
Practice Address - Zip Code:90732-3500
Practice Address - Country:US
Practice Address - Phone:310-514-2300
Practice Address - Fax:310-548-0126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-29
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT46188302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization