Provider Demographics
NPI:1194787507
Name:BEATY, CRAIG LAMAR (DO)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:LAMAR
Last Name:BEATY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:TRADITIONS BEHAVIORAL HEALTH
Mailing Address - Street 2:1580 FIRST STREET
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94559
Mailing Address - Country:US
Mailing Address - Phone:707-258-8757
Mailing Address - Fax:707-253-0457
Practice Address - Street 1:TRADITIONS BEHAVIORAL HEALTH
Practice Address - Street 2:1580 FIRST STREET
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94559
Practice Address - Country:US
Practice Address - Phone:707-258-8757
Practice Address - Fax:707-253-0457
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMA1347052084P0800X
CA20A99052084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry