Provider Demographics
NPI:1871632208
Name:BEHREND, MARION (MFT)
Entity type:Individual
Prefix:
First Name:MARION
Middle Name:
Last Name:BEHREND
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27141 HIDAWAY AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:CANYON COUNTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91351-4131
Mailing Address - Country:US
Mailing Address - Phone:661-252-7026
Mailing Address - Fax:661-252-6839
Practice Address - Street 1:27141 HIDAWAY AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:CANYON COUNTRY
Practice Address - State:CA
Practice Address - Zip Code:91351-4131
Practice Address - Country:US
Practice Address - Phone:661-252-7026
Practice Address - Fax:661-252-6839
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 20767106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA144227OtherVALUE OPTIONS
CA60054OtherAETNA
CAMFT207671OtherBLUE SHIELD OF CALIFORNIA