Provider Demographics
NPI:1992803399
Name:WARDEN, BILLIE L (LMFT)
Entity type:Individual
Prefix:
First Name:BILLIE
Middle Name:L
Last Name:WARDEN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 APPIAN WAY
Mailing Address - Street 2:SUITE #204
Mailing Address - City:PINOLE
Mailing Address - State:CA
Mailing Address - Zip Code:94564-2583
Mailing Address - Country:US
Mailing Address - Phone:510-964-0780
Mailing Address - Fax:925-943-4970
Practice Address - Street 1:2150 APPIAN WAY
Practice Address - Street 2:SUITE #204
Practice Address - City:PINOLE
Practice Address - State:CA
Practice Address - Zip Code:94564-2583
Practice Address - Country:US
Practice Address - Phone:510-964-0780
Practice Address - Fax:925-943-4970
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC34705106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist