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Organization

EAST BAY FAMILY THERAPY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MARC D. KOMORI STAGER PSY.D. (OWNER)
(925) 325-5022
Entity
Organization

Contact information

Practice address
1600 S MAIN ST, SUITE 225, WALNUT CREEK, CA 94596-5340
(925) 325-5022
Mailing address
1600 S MAIN ST, SUITE 225, WALNUT CREEK, CA 94596-5340
(925) 325-5022

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY21734
CA

Other

Enumeration date
09/28/2011
Last updated
09/28/2011
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