Provider Demographics
NPI:1649406422
Name:ECKER, BRUCE MITCHELL (LMFT)
Entity Type:Individual
Prefix:MR
First Name:BRUCE
Middle Name:MITCHELL
Last Name:ECKER
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 BELLEVUE AVE
Mailing Address - Street 2:STE. 202
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610-4923
Mailing Address - Country:US
Mailing Address - Phone:510-452-2820
Mailing Address - Fax:510-465-9980
Practice Address - Street 1:445 BELLEVUE AVE
Practice Address - Street 2:STE. 202
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94610-4923
Practice Address - Country:US
Practice Address - Phone:510-452-2820
Practice Address - Fax:510-465-9980
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-06
Last Update Date:2009-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC21355106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist