Egenberger, Leroy Otto
Egenberger, Leroy Otto is an sole proprietor health care provider with primary practice located at 1101 Standiford Ave Suite B-2, Modesto CA 95350-0982. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Mental Health is his primary health care specialty. Egenberger, Leroy Otto can be contacted via phone (209) 522-5035.Contact Information
Primary practice address
1101 Standiford Ave Suite B-2
Modesto CA 95350-0982
Phone: (209) 522-5035
Fax: (209) 522-5134
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | MFC21358 | California |
| Behavioral Health & Social Service Providers / Marriage & Family Therapist | 106H00000X | MFC21358 | California |
Profile Details
| NPI number | 1922082726 |
|---|---|
| LBN Legal business name | Egenberger, Leroy Otto |
| Credentials | Master of Arts (MA) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 5th, 2005 |
| Last updated | Nov 18th, 2010 - about 16 years ago |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1922082726 | NPPES |
| California | Other | 1922082726 | STANISLAUS COUNTY BEHAVIORAL HEALTH AND RECOVERY SERVICES |
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