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JOHN KENNETH BUKENBERGER MFT

Mental Health >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1871646497

Individual Registrant:
 JOHN KENNETH BUKENBERGER MFT
Gender: M
Not Sole Proprietor

Location and contact information for practice:
52 N TU SU LN  BISHOP, CA 93514-8058 US
Tel: 760-873-6394  Fax: 760-873-3254

Contact information for business:
PO BOX 7979  MAMMOTH LAKES, CA 93546-7979 US
Tel: 760-935-4957  Fax: --

Registration Information:
NPI: 1871646497
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YM0800XBehavioral Health & Social Service Providers
Counselor
Mental Health
CAMFC24829

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
ORGANIZATION NPI NUMBER1659433191CA01




HEALTH CARE JOBS CA - Page 1



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