Doctor Name: | MR. WILLIAM JAMES BEVERLY |
NPI Number: | 1306949425 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | CADC II |
License Number: | A3767997 |
Business Practice Address: | 10633 Grissom Ave Mather, CA - 956554123 |
Business Phone Number: | 9163665440 |
Business Fax Number: | 9163665441 |
Mailing Address: | 10633 Grissom Ave, MATHER |
State: | CA |
Postal Code: | 956554123 |
Phone Number: | 9163665440 |
Fax Number: | 9163665441 |
NPI Enumeration Date: | 09/06/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | A3767997 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |