| East Bay Family Therapy | |
|
1600 S Main St Suite 225 Walnut Creek CA 94596-5340 | |
| (925) 325-5022 | |
| Not Available |
| Full Name | East Bay Family Therapy |
|---|---|
| Speciality | Psychologist |
| Location | 1600 S Main St, Walnut Creek, California |
| Authorized Official Name and Position | Marc D. Komori Stager (OWNER) |
| Authorized Official Contact | 9253255022 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| East Bay Family Therapy 1600 S Main St Suite 225 Walnut Creek CA 94596-5340 Ph: (925) 325-5022 | East Bay Family Therapy 1600 S Main St Suite 225 Walnut Creek CA 94596-5340 Ph: (925) 325-5022 |
| NPI Number | 1952684763 |
|---|---|
| Provider Enumeration Date | 09/28/2011 |
| Last Update Date | 09/28/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952684763 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PSY21734 (California) | Primary |
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