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General NPI Number Information
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NPI Number | 1669523569
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Entity Type | Individual
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Provider Name | BETTINA VON MOLTKE PHD
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Gender | Female
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 09/17/2010
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Provider Practice Location Address
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Address Line | 979 MISSION DE ORO DR STE G
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City | REDDING
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State | CA
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Zip | 96003-3852
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Country | US
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Telephone | 530-949-4148
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Fax | 530-222-4114
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Provider Business Mailing Address
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Address Line | 979 MISSION DE ORO DR STE G
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City | REDDING
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State | CA
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Zip | 96003-3852
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Country | US
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Telephone | 530-949-4148
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Fax | 530-222-4114
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY 18398
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY-202197
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License Number State | ID
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