Basic Information
| Provider Information | |||||||||
| NPI: | 1467050146 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BATTENFIELD | ||||||||
| FirstName: | ABIGAIL | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 5157 | ||||||||
| Address2: | |||||||||
| City: | MODESTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 953525157 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2095722589 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9837 FOLSOM BLVD STE F | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958271356 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9164502600 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/14/2020 | ||||||||
| LastUpdateDate: | 02/18/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/18/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 130080 | CA | N | Behavioral Health & Social Service Providers | Marriage & Family Therapist | 101YM0800X | 10860 | CA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.