# CONSCIOUS MARRIAGE AND FAMILY THERAPY, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326785361
- **Authorized official:** SU BOUDREAU (OWNER)
- **Authorized official phone:** (619) 393-2290

## Contact information

- **Practice address:** 2108 N ST STE N, SACRAMENTO, CA 95816-5712
- **Practice address phone:** (619) 393-2290
- **Mailing address:** 1140 WALL ST \# 355, LA JOLLA, CA 92037-4531

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | Yes |
| 261QM0850X | Adult Mental Health Clinic/Center | — | NULL | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 05/19/2022
- **Last updated:** 09/13/2022