MR. WILLIAM JAMES BEVERLY (NPI# 1306949425) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306949425 |
| Entity Type | Individual |
| Full Name | MR. WILLIAM JAMES BEVERLY |
| Credential | CADC II |
| Practice Address |
10633 Grissom Ave Mather CA 95655-4123 |
| Practice Telephone | 9163665440 |
| Practice Fax Number | 9163665441 |
| Mailing Telephone | 9163665440 |
| Mailing Fax Number | 9163665441 |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
A3767997 | CA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184087009 | William Beverly | Marriage & Family Therapist | 8603 E. Eastridge Dr., Ste A, Prescott Valley, AZ 86314 | 2016-03-29 |
| 1184930117 | William Temple Beverly | Social Worker | 100 W 4th St, Walsenburg, CO 81089-1910 | 2010-08-27 |
| Street Address |
10633 GRISSOM AVE |
| City | MATHER |
| State | CA |
| Zip Code | 95655-4123 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881677706 | David Mark Gellerman | Psychiatry & Neurology | 10633 Grissom Ave, Vanchcs Mental Health Clinic, Mather, CA 95655-4123 | 2005-11-23 |
| 1245351881 | Ronald Edwin Allen | Psychologist | 10633 Grissom Ave, Mather, CA 95655-4123 | 2007-04-02 |
| 1174685051 | Steven Jeffrey Shotz | Psychologist | 10633 Grissom Ave, Mather, CA 95655-4123 | 2006-12-15 |
| 1366411886 | Margaret Denise Tahan | Social Worker | 10633 Grissom Ave, Mather, CA 95655-4123 | 2006-03-16 |
| 1215906060 | Susan Marie Sanfilippo | Psychologist | 10633 Grissom Ave, 116 Mat, Mather, CA 95655-4123 | 2006-03-15 |
| 1619946449 | Melinda Jane Keenan | Psychologist | 10633 Grissom Ave, Mather, CA 95655 | 2006-03-15 |
| 1154397081 | Robert Black Schneider | Psychologist | 10633 Grissom Ave, Mather, CA 95655-4123 | 2006-02-28 |
| 1619943628 | Leroy J Carey II | Counselor | 10633 Grissom Ave, Mather, CA 95655-4123 | 2006-02-28 |
| 1063487817 | Roberta Hopkins | Registered Nurse | 10633 Grissom Ave, Mather, CA 95655-4123 | 2006-02-22 |
| 1598730665 | Edward Lee Eaton | Psychiatry & Neurology | 10633 Grissom Ave, Mather, CA 95655-4123 | 2006-02-21 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720624489 | Sacramento County Office of Education | Clinic/Center | Sacramento County Office of Education/david P. Meaney, 10474 Mather Boulevard, Conference Room A, Mather, CA 95655 | 2019-11-18 |
| 1528539194 | Diana Florina Mccarthy | Pharmacist | 11009 Brattleboro Cir, Mather, CA 95655 | 2018-12-07 |
| 1336235811 | Ian Chan | Internal Medicine | 10565 Hospital Way, Bldg 647, Cardiology Department, Mather, CA 95655 | 2006-10-04 |
| 1790759066 | Tin Zar Shain | Psychiatry & Neurology | 10633 Grissom Avenue, Mather, CA 95655 | 2006-02-14 |
| 1174594659 | Leslie K Eaton | Psychiatry & Neurology | 16033 Grissom Ave, Mather, CA 95655 | 2006-01-31 |
| 1447251681 | Harold A Burger | Internal Medicine | 10535 Hospital Way, Mather Va Hospital, Mather, CA 95655 | 2005-08-10 |
| 1306496799 | Connie Q Sou | Pharmacist | 10535 Hospital Way # 119, Mather, CA 95655 | 2019-09-17 |
| 1356901490 | Sacramento County Office of Education | Local Education Agency (LEA) | 10474 Mather Blvd, Mather, CA 95655 | 2019-06-20 |
| 1255998399 | Wendy Anne Hermes | Dietitian, Registered | 10535 Hospital Way, Bldg 727, Rm 215, Sacramento, CA 95655 | 2019-05-23 |
| 1528595048 | Alissa Goldstein | Psychologist | 10535 Hospital Way, Mather, CA 95655 | 2017-05-15 |
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| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740570357 | Shirley Dean Rowland | Counselor | 3560 Femoyer St Apt 108, Mather, CA 95655-4179 | 2011-04-15 |
| 1912531187 | Reginald Shiffon Daniels | Counselor | 10535 Hospital Way, Mather, CA 95655-4200 | 2020-02-26 |
| 1619943628 | Leroy J Carey II | Counselor | 10633 Grissom Ave, Mather, CA 95655-4123 | 2006-02-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407457377 | Marian Locke | Counselor | 3901 W Adams Blvd, Los Angeles, CA 90018-1756 | 2020-11-05 |
| 1538760871 | Ky Washington | Counselor | 1625 Sweetwater Rd # C1, National City, CA 91950-7647 | 2020-11-03 |
| 1164022976 | Denise Renee Hands | Counselor | 4604 E Terrace Ave, Fresno, CA 93703-2079 | 2020-10-30 |
| 1871193888 | Daniel Luna | Counselor | 811 Beacon Ave, Los Angeles, CA 90017-2113 | 2020-10-28 |
| 1548869266 | Yama Totakhail | Counselor | 915 Bryant St # 94103, San Francisco, CA 94103-4514 | 2020-10-23 |
| 1053910901 | Eduardo Alberto Perez | Counselor | 8829 Dewsbury Ave, San Diego, CA 92126-2428 | 2020-10-21 |
| 1285233155 | Alaric Fairchild | Counselor | 1400 N Johnson Ave Ste 1011400n, El Cajon, CA 92020-1650 | 2020-10-21 |
| 1487253571 | Roxanne Rene Coito | Counselor | 1919 Apple St # D, Oceanside, CA 92054-4425 | 2020-10-20 |
| 1255939732 | Diana Palencia | Counselor | 44459 10th St W, Lancaster, CA 93534-3324 | 2020-10-15 |
| 1962000240 | Frederick P Delafield Iv | Counselor | 679 1/2 Levering Ave, Los Angeles, CA 90024-2350 | 2020-10-09 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.