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MR. DARRYL ANTHONY BENNETT CSII
Mental Health >> Counselor >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1992881924
Individual Registrant:MR. DARRYL ANTHONY BENNETT CSII
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
250 BON AIR RD GREENBRAE, CA 94904 US
Tel: 415-499-6830 Fax: --
Tel: 415-499-6830 Fax: --
Contact information for business:
160 SAWYER ST VALLEJO, CA 94589-2039 US
Tel: 707-557-1688 Fax: --
Tel: 707-557-1688 Fax: --
Registration Information:
NPI: 1992881924
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 101YM0800X | Behavioral Health & Social Service Providers Counselor Mental Health | CA | PT 24852 |
| Y | 167G00000X | Nursing Service Providers Licensed Psychiatric Technician | CA | PT 24852 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
