Provider Demographics
NPI:1790891604
Name:BEDRIN, MARGARET M (MARRIAGE FAM THPST)
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:M
Last Name:BEDRIN
Suffix:
Gender:F
Credentials:MARRIAGE FAM THPST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX #3605
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598
Mailing Address - Country:US
Mailing Address - Phone:925-825-1187
Mailing Address - Fax:925-825-7430
Practice Address - Street 1:1280 BOULEVARD WAY
Practice Address - Street 2:#308
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94595
Practice Address - Country:US
Practice Address - Phone:925-825-1187
Practice Address - Fax:925-825-7430
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28904103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
18935634OtherBLUE CROSS
7368119OtherAETNA
066495OtherMANAGED HEALTH NETWORK
101684OtherMAGELLAN