| Pacific Mft Network | |
|
2716 Ocean Park Blvd Ste 3075 Santa Monica CA 90405-5232 | |
| (310) 612-2998 | |
| Not Available |
| Full Name | Pacific Mft Network |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 2716 Ocean Park Blvd Ste 3075, Santa Monica, California |
| Authorized Official Name and Position | Tracy Kovacs Bevington (PRESIDENT) |
| Authorized Official Contact | 3102262826 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pacific Mft Network 2716 Ocean Park Blvd Ste 3075 Santa Monica CA 90405-5232 Ph: (310) 612-2998 | Pacific Mft Network 2716 Ocean Park Blvd Ste 3075 Santa Monica CA 90405-5232 Ph: (310) 612-2998 |
| NPI Number | 1558720904 |
|---|---|
| Provider Enumeration Date | 02/14/2016 |
| Last Update Date | 05/05/2022 |
| Certification Date | 05/05/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558720904 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 53455 (California) | Primary |
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