Individual provider · Type 1 NPI

Elliott Nicholas Beverley Jr.

Mental Health Counselor · San Leandro, CA

NPI number 1194858092 Active

Practice location

2275 Arlington Dr
San Leandro, CA 94578-1132

Mailing address

6 Kamson Ct
Sacramento, CA 95833-2604

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

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About NPI 1194858092

Elliott Nicholas Beverley Jr.'s National Provider Identifier is 1194858092, issued on Mar 13, 2007. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in San Leandro, CA. The record was last updated on Jul 8, 2007.