Provider Demographics
NPI:1750682191
Name:STRACH, BETTY ANN (MFT)
Entity Type:Individual
Prefix:MS
First Name:BETTY
Middle Name:ANN
Last Name:STRACH
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 1ST ST STE D309
Mailing Address - Street 2:
Mailing Address - City:LAKEPORT
Mailing Address - State:CA
Mailing Address - Zip Code:95453-4839
Mailing Address - Country:US
Mailing Address - Phone:707-263-3670
Mailing Address - Fax:707-263-3690
Practice Address - Street 1:55 1ST ST STE D309
Practice Address - Street 2:
Practice Address - City:LAKEPORT
Practice Address - State:CA
Practice Address - Zip Code:95453-4839
Practice Address - Country:US
Practice Address - Phone:707-263-3670
Practice Address - Fax:707-263-3690
Is Sole Proprietor?:No
Enumeration Date:2010-11-16
Last Update Date:2023-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC21907106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist