TIA BRISCO, LICENSED MARRIAGE AND FAMILY THERAPY, INC.


Address: 17130 Devonshire St Ste 104a, Northridge, CA 91325-1676
Phone: 6616758756

TIA BRISCO, LICENSED MARRIAGE AND FAMILY THERAPY, INC. (NPI# 1043840192) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1043840192
Entity Type Organization
Organization Name TIA BRISCO, LICENSED MARRIAGE AND FAMILY THERAPY, INC.
Practice Address 17130 Devonshire St Ste 104a
Northridge
CA 91325-1676
Practice Telephone 6616758756
Mailing Telephone 6616758756
Enumeration Date 2020-01-16
Last Update Date 2020-04-25
Authorized Official Name TIA BRISCO (OWNER)
Authorized Official Telephone 6616758756
Authorized Official Credential LMFT
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 261QM0855X Clinic/Center
Specialization: Adolescent and Children Mental Health
Ambulatory Health Care Facilities
Y 261QM0850X Clinic/Center
Specialization: Adult Mental Health
Ambulatory Health Care Facilities

Provider Secondary Practice Location

Address Telephone Number Fax Number
190 Sierra Ct Ste 326, Palmdale, CA 935507619 6616758756

Office Location

Street Address 17130 DEVONSHIRE ST STE 104A
City NORTHRIDGE
State CA
Zip Code 91325-1676

Providers in the same location

NPI Name Taxonomy Address Enumeration
1417464793 A Vision of Health Public Health or Welfare 17130 Devonshire St Ste 104a, Northridge, CA 91325-1676 2018-01-08
1104454073 Susana Guadalupe Cortez Health Educator 17130 Devonshire St Ste 104a, Northridge, CA 91325-1676 2020-03-27
1770056236 Norma Hernandez Prevention Professional 17130 Devonshire St Ste 104a, Northridge, CA 91325-1676 2019-01-08

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Taxonomy Information

Taxonomy Code 261QM0850X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Adult Mental Health

Taxonomy Definition

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.
Notes: [7/1/2003: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1144883489 Better Sober Clinic/Center 9339 Louse Ave, Northridge, CA 91325 2019-04-22

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
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Competitor

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City NORTHRIDGE
Zip Code 91325

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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