MEDICARE: ROBERT BERRY MCVAUGH M.A., LMFT

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	MFC39257	CA

General Provider Information

NPI Number	:	1184817488
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT BERRY MCVAUGH M.A., LMFT

Provider Business Mailing Address
First Line	:	6006 BROKEN ARROW COURT
Second Line	:
City	:	CITRUS HEIGHTS
State	:	CA
Zip	:	95621
Country	:	US
Telephone Number	:	916-847-4768
Fax Number	:	916-722-9229

Provider Business Practice Location Address
First Line	:	6006 BROKEN ARROW COURT
Second Line	:
City	:	CITRUS HEIGHTS
State	:	CA
Zip	:	95621
Country	:	US
Telephone Number	:	916-847-4768
Fax Number	:	916-722-9229

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

Provider Enumeration Date	:	08/21/2007
Last Update Date	:	04/01/2015

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