Provider Demographics
NPI:1982751467
Name:SIEGEL, ESTHER RUTHE (MFT)
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:RUTHE
Last Name:SIEGEL
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:PO BOX 420
Mailing Address - Street 2:
Mailing Address - City:REDWOOD VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95470-0420
Mailing Address - Country:US
Mailing Address - Phone:707-485-5354
Mailing Address - Fax:707-485-7615
Practice Address - Street 1:8233 PINECREST DRIVE
Practice Address - Street 2:
Practice Address - City:REDWOOD VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95470-9547
Practice Address - Country:US
Practice Address - Phone:707-485-5354
Practice Address - Fax:707-485-7615
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 28728106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist