1043356512 NPI number — MRS. SYLVIA KATHRYN BENZLER MFT

Table of content: MRS. SYLVIA KATHRYN BENZLER MFT (NPI 1043356512)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043356512 NPI number — MRS. SYLVIA KATHRYN BENZLER MFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BENZLER
Provider First Name:
SYLVIA
Provider Middle Name:
KATHRYN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1043356512
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 LA SERENA AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALAMO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94507-2121
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
925-820-0296
Provider Business Mailing Address Fax Number:
925-820-4643

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
145 EAST PROSPECT AVE.
Provider Second Line Business Practice Location Address:
SUITE 215C
Provider Business Practice Location Address City Name:
DANVILLE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94526-3869
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
925-855-8500
Provider Business Practice Location Address Fax Number:
925-820-4643
Provider Enumeration Date:
01/30/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  MFT 15108 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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