# MID-PENINSULA EATING DISORDER CLINIC, A MARRIAGE AND FAMILY THERAPY CO

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MPEDC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093190407
- **Authorized official:** MS. WENDI JO CONLEY (BILLING MANAGER)
- **Authorized official phone:** (424) 298-8901

## Contact information

- **Practice address:** 220 CALIFORNIA AVE STE 100, PALO ALTO, CA 94306-1627
- **Practice address phone:** (650) 319-7225
- **Practice address fax:** (650) 618-5556
- **Mailing address:** 220 CALIFORNIA AVE STE 100, PALO ALTO, CA 94306-1627
- **Mailing address phone:** (650) 319-7225
- **Mailing address fax:** (650) 618-5556

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | LMFT44947 | CA | Yes |

## Other

- **Enumeration date:** 07/27/2015
- **Last updated:** 10/30/2020