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:
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Health care specialties

SpecialtyCodeLicense #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 15 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922082726 NPPES
California Other 1922082726 STANISLAUS COUNTY BEHAVIORAL HEALTH AND RECOVERY SERVICES

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