# WEST COAST INDIVIDUAL AND FAMILY THERAPY INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** West Coast Therapy Group.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245064245
- **Authorized official:** MR. MARK RAYMOND GERY LMFT (OWNER)
- **Authorized official phone:** (714) 222-3864

## Contact information

- **Practice address:** 10061 TALBERT AVE, SUITE 200/365, FOUNTAIN VALLEY, CA 92708
- **Practice address phone:** (714) 222-3864
- **Practice address fax:** (714) 963-4703
- **Mailing address:** 2709 SOUTH DIAMOND STREET, SANTA ANA, CA 92704
- **Mailing address phone:** (714) 222-3864

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 08/30/2024
- **Last updated:** 08/30/2024