Most Relevant Information
Provider Data
| NPI Number: | 1003356791 |
| Provider Name: | NATHAN BEVENS |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: | 75856 |
Most Important Dates
| Enumeration Date: | 03/01/2017 |
| Last Updated: | 03/17/2018 |
Provider Practice Location
50 BRANSCOMB RD
LAYTONVILLE
CA
95454
Practice Location Phone/Fax
| Phone: | 7079846131 |
| Fax: |
Provider Mailing Location
PO BOX 870
LAYTONVILLE
CA
954540870
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |