Provider Demographics
NPI:1437284387
Name:WASHINGTON, BEVERLY YVONNE
Entity Type:Individual
Prefix:MRS
First Name:BEVERLY
Middle Name:YVONNE
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 W WILLIAMS ST APT C
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93458-1748
Mailing Address - Country:US
Mailing Address - Phone:805-352-0128
Mailing Address - Fax:
Practice Address - Street 1:731 S LINCOLN ST
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93458-6107
Practice Address - Country:US
Practice Address - Phone:805-346-8185
Practice Address - Fax:805-346-8656
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)