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General NPI Number Information
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NPI Number | 1912036088
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Entity Type | Individual
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Provider Name | BEVERLY EDGREN HALL LMFT
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Gender | Female
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 08/23/2007
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Provider Practice Location Address
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Address Line | 931 HARTZ WAY SUITE 130
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City | DANVILLE
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State | CA
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Zip | 94526-3465
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Country | US
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Telephone | 925-891-8791
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Fax |
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Provider Business Mailing Address
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Address Line | 212 PARK PL
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City | SAN RAMON
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State | CA
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Zip | 94583-5373
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Country | US
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Telephone | 925-891-8791
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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 | MFC 37566
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | RN 381567
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License Number State | CA
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