Avery, Betty

Avery, Betty is an sole proprietor health care provider with primary practice located at 12469 Kokomo Cir , Victorville CA 92392-7484. She recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as her primary health care specialty. Avery, Betty can be contacted via phone (760) 503-5272.

Contact Information

Primary practice address
12469 Kokomo Cir Victorville CA 92392-7484
Phone: (760) 503-5272
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 83124 California
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 128189 California

Profile Details

NPI number 1417489733
LBN Legal business name Avery, Betty
Credentials LMFT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 28th, 2017
Last updated Jun 16th, 2025 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417489733 NPPES
California MEDICAID 90-0996079

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