Provider Demographics
NPI:1760772073
Name:BATTER, BRENT KELLER
Entity Type:Individual
Prefix:MR
First Name:BRENT
Middle Name:KELLER
Last Name:BATTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 CATALPA CT
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-6609
Mailing Address - Country:US
Mailing Address - Phone:707-339-2098
Mailing Address - Fax:
Practice Address - Street 1:10 CATALPA CT
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-6609
Practice Address - Country:US
Practice Address - Phone:707-339-2098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-08
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86296101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health