| Mrs Tyra Bennett, LMFT #111017 | |
|
3559 Mt Diablo Blvd Unit 190, Lafayette, CA 94549-3876 | |
| (909) 961-5128 | |
| Not Available |
| Full Name | Mrs Tyra Bennett |
|---|---|
| Gender | Female |
| Speciality | Marriage & Family Therapist |
| Location | 3559 Mt Diablo Blvd Unit 190, Lafayette, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235576794 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 111017 (California) | Primary |
| Entity Name | Permanente Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Tyra Bennett, LMFT #111017 3559 Mt Diablo Blvd Unit 190, Lafayette, CA 94549-3876 Ph: (909) 961-5128 | Mrs Tyra Bennett, LMFT #111017 3559 Mt Diablo Blvd Unit 190, Lafayette, CA 94549-3876 Ph: (909) 961-5128 |
Leslie Foge, MA, MFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 954 Risa Rd, Suite A, Lafayette, CA 94549 Phone: 510-332-2649 | |
Pierre Francois Vilanoba, Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 3468 Mt Diablo Blvd Ste B201, Lafayette, CA 94549 Phone: 925-284-2298 | |
Mrs. Lifan Wang Koerner, AMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 986 Moraga Rd, Lafayette, CA 94549 Phone: 925-954-6229 Fax: 925-269-8052 | |
Ann Sarene Russum, Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 3744 Mt Diablo Blvd Ste 206, Lafayette, CA 94549 Phone: 925-788-7599 | |
Lisa M Lewis, MA Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 954 Risa Rd Ste A, Lafayette, CA 94549 Phone: 925-388-9228 | |
Ariana Dulberg, LMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 3468 Mt Diablo Blvd, Lafayette, CA 94549 Phone: 415-741-0308 | |
Valerie Maria Beltran, Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 3468 Mt Diablo Blvd Ste B201, Lafayette, CA 94549 Phone: 925-297-5230 |