MEDICARE: MR. BENJAMIN TYLER SEIGLER MFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	49211	CA

General Provider Information

NPI Number	:	1053579706
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BENJAMIN TYLER SEIGLER MFT

Provider Business Mailing Address
First Line	:	1095 STAFFORD WAY
Second Line	:	STE. F
City	:	YUBA CITY
State	:	CA
Zip	:	95991-3333
Country	:	US
Telephone Number	:	530-966-1242
Fax Number	:

Provider Business Practice Location Address
First Line	:	1095 STAFFORD WAY
Second Line	:	STE. F
City	:	YUBA CITY
State	:	CA
Zip	:	95991-3333
Country	:	US
Telephone Number	:	530-966-1242
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/29/2008
Last Update Date	:	07/20/2015

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