Provider Demographics
NPI:1205027737
Name:BECKETT, CRAIG (LMFT)
Entity type:Individual
Prefix:
First Name:CRAIG
Middle Name:
Last Name:BECKETT
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43537 RIDGE PARK DR
Mailing Address - Street 2:#208
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-3615
Mailing Address - Country:US
Mailing Address - Phone:951-333-4298
Mailing Address - Fax:
Practice Address - Street 1:43537 RIDGE PARK DR
Practice Address - Street 2:#208
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-3615
Practice Address - Country:US
Practice Address - Phone:951-333-4298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-08
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC37513106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist