Provider Demographics
NPI:1184916470
Name:MINEHAN, BETTY (PSYD,MED,MHS,MBA,MA,)
Entity type:Individual
Prefix:DR
First Name:BETTY
Middle Name:
Last Name:MINEHAN
Suffix:
Gender:F
Credentials:PSYD,MED,MHS,MBA,MA,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 S. GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:SANATA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705
Mailing Address - Country:US
Mailing Address - Phone:626-675-9219
Mailing Address - Fax:
Practice Address - Street 1:101 S. GRAND AVE
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705
Practice Address - Country:US
Practice Address - Phone:626-675-9219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-05
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist