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General NPI Number Information
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NPI Number | 1588004782
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Entity Type | Organization
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Legal Business Name | GERALD BETZEN MFT, INC.
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Dates
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Enumeration Date | 07/02/2013
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Last Update Date | 07/02/2013
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Provider Practice Location Address
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Address Line | 337 S BEVERLY DR STE. 207
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City | BEVERLY HILLS
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State | CA
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Zip | 90212-4315
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Country | US
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Telephone | 310-271-2001
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Fax | 310-843-9864
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Provider Business Mailing Address
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Address Line | 337 S BEVERLY DR STE. 207
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City | BEVERLY HILLS
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State | CA
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Zip | 90212-4315
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Country | US
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Telephone | 310-271-2001
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Fax | 310-843-9864
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. GERALD C BETZEN
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Credential | MFT
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Telephone | 310-271-2001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | MFC33284
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License Number State | CA
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