Provider Demographics
NPI:1285739342
Name:ALPERT, BETTY JEAN (MFT)
Entity type:Individual
Prefix:
First Name:BETTY
Middle Name:JEAN
Last Name:ALPERT
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:595 BUCK AVE
Mailing Address - Street 2:SUITE G
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95688-3642
Mailing Address - Country:US
Mailing Address - Phone:707-446-6199
Mailing Address - Fax:707-447-6909
Practice Address - Street 1:595 BUCK AVE
Practice Address - Street 2:SUITE G
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95688-3642
Practice Address - Country:US
Practice Address - Phone:707-446-6199
Practice Address - Fax:707-447-6909
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT32028106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMFT32028OtherLICENSE