Provider Demographics
NPI:1790900819
Name:DALPORTO, BECKY JANE (MFT)
Entity Type:Individual
Prefix:MS
First Name:BECKY
Middle Name:JANE
Last Name:DALPORTO
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 1:12755 NORTH HWY 88
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:CA
Mailing Address - Zip Code:95240
Mailing Address - Country:US
Mailing Address - Phone:209-340-7900
Mailing Address - Fax:209-340-7960
Practice Address - Street 1:12755 NORTH HWY 88
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:CA
Practice Address - Zip Code:95240
Practice Address - Country:US
Practice Address - Phone:209-340-7900
Practice Address - Fax:209-340-7960
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2016-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC28351106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist