Provider Demographics
NPI:1215031307
Name:BEECHEL, CHRISTOPHER STORM (MA MFT)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:STORM
Last Name:BEECHEL
Suffix:
Gender:M
Credentials:MA MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2255 MYRTLE AVENUE
Mailing Address - Street 2:SUITE A
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-3386
Mailing Address - Country:US
Mailing Address - Phone:707-443-5768
Mailing Address - Fax:707-443-8961
Practice Address - Street 1:2255 MYRTLE AVENUE
Practice Address - Street 2:SUITE A
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-3386
Practice Address - Country:US
Practice Address - Phone:707-443-5768
Practice Address - Fax:707-443-8961
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC22051106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA067473OtherMHN