Provider Demographics
NPI:1760790323
Name:FORDEN, DAVID HAROLD (MFT)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:HAROLD
Last Name:FORDEN
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10400 WALNUT CREEK CT
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-2762
Mailing Address - Country:US
Mailing Address - Phone:661-664-8123
Mailing Address - Fax:
Practice Address - Street 1:10400 WALNUT CREEK CT
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-2762
Practice Address - Country:US
Practice Address - Phone:661-664-8123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-16
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 18314106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist