| Central Coast Counseling Center | |
|
2355 Lake Marie Drive Santa Maria CA 93455-5709 | |
| (805) 934-5088 | |
| (805) 937-0877 |
| Full Name | Central Coast Counseling Center |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 2355 Lake Marie Drive, Santa Maria, California |
| Authorized Official Name and Position | Mary Jo Pedersen (LMFT & OWNER OF C.C.C.C., INC.) |
| Authorized Official Contact | 8052642584 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Central Coast Counseling Center P.o. Box 2234 Santa Maria CA 93457-2234 Ph: (805) 264-2584 | Central Coast Counseling Center 2355 Lake Marie Drive Santa Maria CA 93455-5709 Ph: (805) 934-5088 |
| NPI Number | 1861686602 |
|---|---|
| Provider Enumeration Date | 09/05/2007 |
| Last Update Date | 04/19/2023 |
| Certification Date | 04/19/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861686602 | NPI | - | NPPES |
| ZZZ69883Z | Other | CA | BLUE SHIELD |
| 11688700 | Other | CA | BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 38335 (California) | Primary |
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