Provider Demographics
NPI:1184177495
Name:CHAVEZ, BEATRIZ (LMFT)
Entity type:Individual
Prefix:
First Name:BEATRIZ
Middle Name:
Last Name:CHAVEZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1903 BERKELEY WAY UNIT 5
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94704-1007
Mailing Address - Country:US
Mailing Address - Phone:925-257-4196
Mailing Address - Fax:
Practice Address - Street 1:1903 BERKELEY WAY UNIT 5
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94704-1007
Practice Address - Country:US
Practice Address - Phone:925-257-4196
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-03
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000101Y00000X
CA101406106H00000X
CA125229106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor