Basic Information
| Provider Information | |||||||||
| NPI: | 1407944119 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MILFORD | ||||||||
| FirstName: | BETH | ||||||||
| MiddleName: | WHARTON | ||||||||
| NamePrefix: | |||||||||
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| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | MILFORD | ||||||||
| OtherFirstName: | BETH | ||||||||
| OtherMiddleName: | WHARTON | ||||||||
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| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1441 CONSTITUTION BOULEVARD | ||||||||
| Address2: | BUILDING 400, SUITE 202 | ||||||||
| City: | SALINAS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94906 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7146252526 | ||||||||
| FaxNumber: | 8317690552 | ||||||||
| Practice Location | |||||||||
| Address1: | 1200 AGUAJITO RD | ||||||||
| Address2: | MONTEREY COUNTY BEHAVIORAL HEALTH | ||||||||
| City: | MONTEREY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939404887 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7146252526 | ||||||||
| FaxNumber: | 8317690552 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/10/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | G33280 | CA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 00G332800 | 05 | CA | MEDICAID |