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NPI Code Detail

MEDICARE: BET BUCHANAN LMFT

MEDICARE: BET BUCHANAN 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
1106H00000XMarriage & Family Therapist

General Provider Information

NPI Number : 1902960867
Entity Type Code : Individual
Provider Name (Legal Business Name) : BET BUCHANAN LMFT
Provider Business Mailing Address
First Line : 666 7TH ST
Second Line :
City : SANTA ROSA
State : CA
Zip : 95404-4245
Country : US
Telephone Number : 707-575-9166
Fax Number : 707-528-2279
Provider Business Practice Location Address
First Line : 2100 GENG RD STE 210
Second Line :
City : PALO ALTO
State : CA
Zip : 94303-3307
Country : US
Telephone Number : 833-646-3243
Fax Number : 707-528-2279
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/21/2006
Last Update Date : 07/06/2024

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