Provider Demographics
NPI:1497859011
Name:COVEN, BERDEEN E (LMFT, PHD)
Entity Type:Individual
Prefix:DR
First Name:BERDEEN
Middle Name:E
Last Name:COVEN
Suffix:
Gender:F
Credentials:LMFT, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1475 S BASCOM AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-0624
Mailing Address - Country:US
Mailing Address - Phone:408-255-1884
Mailing Address - Fax:408-559-1890
Practice Address - Street 1:1475 S BASCOM AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-0624
Practice Address - Country:US
Practice Address - Phone:408-255-1884
Practice Address - Fax:408-559-1890
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 12556103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist