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General NPI Number Information
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NPI Number | 1821691858
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Entity Type | Individual
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Provider Name | BYRON WATTREE MS, AMFT, CATCIII
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Gender | Male
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Dates
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Enumeration Date | 11/20/2020
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Last Update Date | 06/27/2025
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Provider Practice Location Address
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Address Line | 1481 WINDSOR DR
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City | SAN BERNARDINO
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State | CA
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Zip | 92404-5416
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Country | US
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Telephone | 909-476-2023
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Fax |
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Provider Business Mailing Address
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Address Line | 1481 WINDSOR DR
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City | SAN BERNARDINO
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State | CA
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Zip | 92404-5416
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Country | US
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Telephone | 909-361-6470
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 202368III
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 154846
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License Number State | CA
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