Provider Demographics
NPI:1649391897
Name:TARBUTTON, BENJAMIN DAVID (BA)
Entity Type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:DAVID
Last Name:TARBUTTON
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 PACIFICA AVENUE
Mailing Address - Street 2:
Mailing Address - City:BAY POINT
Mailing Address - State:CA
Mailing Address - Zip Code:94565-2901
Mailing Address - Country:US
Mailing Address - Phone:925-458-3216
Mailing Address - Fax:925-458-7623
Practice Address - Street 1:205 PACIFICA AVENUE
Practice Address - Street 2:
Practice Address - City:BAY POINT
Practice Address - State:CA
Practice Address - Zip Code:94565-2904
Practice Address - Country:US
Practice Address - Phone:925-458-3216
Practice Address - Fax:925-458-7623
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor