Provider Demographics
NPI:1023209004
Name:TESTARD, AARON R I (MFTI)
Entity Type:Individual
Prefix:MR
First Name:AARON
Middle Name:R
Last Name:TESTARD
Suffix:I
Gender:M
Credentials:MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2006 DWIGHT WAY STE 103
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94704-2633
Mailing Address - Country:US
Mailing Address - Phone:510-763-0308
Mailing Address - Fax:866-488-0555
Practice Address - Street 1:2006 DWIGHT WAY STE 103
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94704-2633
Practice Address - Country:US
Practice Address - Phone:510-763-0308
Practice Address - Fax:866-488-0555
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-06
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT45320106H00000X
CALPC1379101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional