Provider Demographics
NPI:1982808135
Name:DESCHAUX, BEVERLY GAIL (MFT)
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:GAIL
Last Name:DESCHAUX
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 2041
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95063-2041
Mailing Address - Country:US
Mailing Address - Phone:831-427-4044
Mailing Address - Fax:
Practice Address - Street 1:542 OCEAN ST STE J
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-6622
Practice Address - Country:US
Practice Address - Phone:831-427-4044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC32735106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist