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General NPI Number Information
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NPI Number | 1073631545
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Entity Type | Organization
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Legal Business Name | BEVERLY HANES, LMFT APC
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1420 E COOLEY DR SUITE 200 S
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City | COLTON
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State | CA
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Zip | 92324-3981
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Country | US
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Telephone | 951-334-3177
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Fax | 909-424-0222
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Provider Business Mailing Address
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Address Line | PO BOX 52974
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City | RIVERSIDE
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State | CA
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Zip | 92517-3974
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Country | US
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Telephone | 951-334-3177
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Fax | 909-424-0222
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Authorized Official
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Title or Position | MARRIAGE & FAMILY THERAPIST-CEO
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Name | MS. BEVERLY HANES
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Credential | M.A., LMFT
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Telephone | 951-334-3177
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | CORP 2879938
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License Number State | CA
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