Larry L Brashaw, MFT I

Individual provider Active NPI Marriage & Family Therapist · Oroville, CA

NPI 1164580502 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1164580502
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
MFTI 48878 (CA)
Practice address
2858 Olive Highway
Suites a, B, & C
Oroville, CA 95966
Phone
(530) 538-2158
Fax
(530) 533-7188
NPI assigned
Dec 5, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
MFTI 48878CAMDMarriage & Family Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFTI 48878 CA Yes

Addresses

Primary practice location

2858 Olive Highway
Suites a, B, & C
Oroville, CA 95966

Mailing address

PO Box 474
Forest Ranch, CA 95942
Phone (530) 892-1417

Other identifiers

IdentifierTypeStateIssuer
48878OtherCAIMF

Other providers in Oroville, CA

All providers in Oroville, CA · Marriage & Family Therapist in California

Sources for this page

Verify at the official NPI Registry.