Provider Demographics
NPI:1386705556
Name:BULCROFT, STEVEN JOHN (STEVEN BULCROFT)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:JOHN
Last Name:BULCROFT
Suffix:
Gender:M
Credentials:STEVEN BULCROFT
Other - Prefix:MR
Other - First Name:STEVE
Other - Middle Name:
Other - Last Name:BULCROFT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MFT
Mailing Address - Street 1:117 N OREGON ST
Mailing Address - Street 2:
Mailing Address - City:YREKA
Mailing Address - State:CA
Mailing Address - Zip Code:96097-2406
Mailing Address - Country:US
Mailing Address - Phone:530-842-1920
Mailing Address - Fax:530-842-1920
Practice Address - Street 1:117 N. OREGON STREET
Practice Address - Street 2:
Practice Address - City:YREKA
Practice Address - State:CA
Practice Address - Zip Code:96997
Practice Address - Country:US
Practice Address - Phone:530-842-1920
Practice Address - Fax:530-842-1920
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2010-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 19340106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist