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Organization
PSYCHOSOCIAL THERAPY LICENSED MARRIAGE AND FAMILY THERAPISTS INC.
Active
Organization
PSYCHOSOCIAL THERAPY LICENSED MARRIAGE AND FAMILY THERAPISTS INC.
Active
Other names
PsychoSocial Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
LUIS ALFREDO CORNEJO LMFT (PRESIDENT)
(510) 288-6336
Entity
Organization
Contact information
Practice address
1918 BONITA AVE STE 200, BERKELEY, CA 94704-1014
(510) 288-6336
Mailing address
1918 BONITA AVE STE 200, BERKELEY, CA 94704-1014
(510) 288-6336
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
NULL
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
02/01/2022
Last updated
02/01/2022
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