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NPI Code Detail

MEDICARE: MR. TIM HESGARD MFT

MEDICARE: MR. TIM HESGARD MFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family TherapistMFC42835CA

General Provider Information

NPI Number : 1679589766
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. TIM HESGARD MFT
Provider Business Mailing Address
First Line : 1 QUALITY DRIVE
Second Line :
City : VACAVILLE
State : CA
Zip : 95688-9494
Country : US
Telephone Number : 707-624-4000
Fax Number :
Provider Business Practice Location Address
First Line : 1 QUALITY DRIVE
Second Line :
City : VACAVILLE
State : CA
Zip : 95688-9494
Country : US
Telephone Number : 707-624-4000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2006
Last Update Date : 02/11/2022

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