1821708694 NPI number — JUDITH LUCIA I. ALBANO, A MARRIAGE AND FAMILY THERAPY CORPORATION

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821708694 NPI number — JUDITH LUCIA I. ALBANO, A MARRIAGE AND FAMILY THERAPY CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JUDITH LUCIA I. ALBANO, A MARRIAGE AND FAMILY THERAPY CORPORATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821708694
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/01/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
55 CHICAGO WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN FRANCISCO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94112-4533
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
415-533-5028
Provider Business Mailing Address Fax Number:
415-480-1444

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
80 EUREKA SQ STE 215
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PACIFICA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94044-2677
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-269-5254
Provider Business Practice Location Address Fax Number:
415-480-1444
Provider Enumeration Date:
12/01/2022

Additional Information

Authorized Official

Authorized Official Last Name:
ALBANO
Authorized Official First Name:
JUDITH LUCIA
Authorized Official Middle Name:
IGNACIO
Authorized Official Title or Position:
LICENSED MARRIAGE AND FAMILY THERAP
Authorized Official Telephone Number:
415-269-5254

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 105832 . This is a "LICENSE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 105832 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com