| Golden State Marriage And Family Therapy, A Professional Corporation | |
|
250 El Camino Real Ste 213 Tustin CA 92780-3656 | |
| (657) 900-8655 | |
| (657) 900-8656 |
| Full Name | Golden State Marriage And Family Therapy, A Professional Corporation |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 250 El Camino Real Ste 213, Tustin, California |
| Authorized Official Name and Position | Janet Basalone (PRESIDENT AND PSYCHOTHERAPIST) |
| Authorized Official Contact | 6579008655 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Golden State Marriage And Family Therapy, A Professional Corporation 250 El Camino Real Ste 213 Tustin CA 92780-3656 Ph: (657) 900-8655 | Golden State Marriage And Family Therapy, A Professional Corporation 250 El Camino Real Ste 213 Tustin CA 92780-3656 Ph: (657) 900-8655 |
| NPI Number | 1750040499 |
|---|---|
| Provider Enumeration Date | 12/09/2021 |
| Last Update Date | 12/09/2021 |
| Certification Date | 12/09/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750040499 | NPI | - | NPPES |
| 1053664649 | Other | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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