Provider Demographics
NPI:1245369354
Name:AUSTIN, RONALD D (MFT)
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:D
Last Name:AUSTIN
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:299 SANDY NECK WAY
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94591-7851
Mailing Address - Country:US
Mailing Address - Phone:925-457-8775
Mailing Address - Fax:530-666-8294
Practice Address - Street 1:137 N. COTTONWOOD STREET
Practice Address - Street 2:SUITE 2500
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695
Practice Address - Country:US
Practice Address - Phone:530-666-8634
Practice Address - Fax:530-666-8294
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 41803106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist