Provider Demographics
NPI:1508085804
Name:BYRD, VICTOR L (PSYD)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:L
Last Name:BYRD
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 HERMOSA AVE
Mailing Address - Street 2:3 J
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-6110
Mailing Address - Country:US
Mailing Address - Phone:562-437-4790
Mailing Address - Fax:
Practice Address - Street 1:5855 E NAPLES PLZ
Practice Address - Street 2:ST. 116
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90803-5060
Practice Address - Country:US
Practice Address - Phone:562-439-0934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC32883106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist