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General NPI Number Information
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NPI Number | 1952331134
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Entity Type | Organization
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Legal Business Name | BEHAVIORAL HEALTH FAMILY COUNSELING & EDUCATIONAL CONSULTING, PC
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2055 ANDERSON RD # 5
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City | DAVIS
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State | CA
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Zip | 95616-0672
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Country | US
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Telephone | 530-758-7163
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Fax | 530-758-1021
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Provider Business Mailing Address
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Address Line | 3415 BRETON AVE
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City | DAVIS
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State | CA
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Zip | 95616-2709
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Country | US
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Telephone | 530-758-1021
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Fax | 530-758-1021
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Authorized Official
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Title or Position | MARRIAGE FAMILY THERAPIST
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Name | MS. TERI ANNE DRAKE
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Credential | RN, MFT
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Telephone | 530-758-7163
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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 | MFC31131
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License Number State | CA
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