Provider Demographics
NPI:1922100460
Name:BOYD, BETTE (MFT)
Entity Type:Individual
Prefix:MRS
First Name:BETTE
Middle Name:
Last Name:BOYD
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 1:140 W 220TH ST UNIT 106
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90745-2968
Mailing Address - Country:US
Mailing Address - Phone:310-518-1681
Mailing Address - Fax:
Practice Address - Street 1:140 W 220TH ST UNIT 106
Practice Address - Street 2:
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90745-2968
Practice Address - Country:US
Practice Address - Phone:310-418-9661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-04
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMT15220101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health