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General NPI Number Information
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NPI Number | 1790412369
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Entity Type | Individual
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Provider Name | BENERALDA MARIA GALVAN
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Gender | Female
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Dates
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Enumeration Date | 08/04/2022
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Last Update Date | 08/04/2022
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Provider Practice Location Address
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Address Line | 1304 EAST ST STE 203
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City | REDDING
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State | CA
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Zip | 96001-0855
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Country | US
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Telephone | 916-581-0340
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Fax |
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Provider Business Mailing Address
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Address Line | 23400 HILLMAN CT
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City | RED BLUFF
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State | CA
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Zip | 96080-9008
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Country | US
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Telephone | 530-209-7329
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Fax |
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 133721
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License Number State | CA
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