Provider Demographics
NPI:1831948538
Name:MJB FAMILY AND MARRIAGE THERAPIST INC
Entity type:Organization
Organization Name:MJB FAMILY AND MARRIAGE THERAPIST INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:JEANNE
Authorized Official - Last Name:BEZUCHA
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:213-300-8075
Mailing Address - Street 1:2366 LAVERNA AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90041-2627
Mailing Address - Country:US
Mailing Address - Phone:213-300-8075
Mailing Address - Fax:
Practice Address - Street 1:16 N MARENGO AVE STE 211
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-1966
Practice Address - Country:US
Practice Address - Phone:213-300-8075
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty