MR. LEROY OTTO EGENBERGER MA NPI 1922082726

NPI Information

NPI: 1922082726
Provider Name: MR. LEROY OTTO EGENBERGER, MA
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
1101 STANDIFORD AVE
SUITE B-2
MODESTO, CA
ZIP 95350
Phone: (209) 522-5035
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MR. Leroy Otto Egenberger, MA is a mental health counselor in Modesto, CA. MR. Leroy Otto Egenberger, MA NPI is 1922082726. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1101 STANDIFORD AVE
SUITE B-2
MODESTO, CA
ZIP 95350-982
Phone: (209) 522-5035
Fax: (209) 522-5134

The enumeration date for this NPI number is 12/5/2005 and was last updated on 11/18/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	106H00000X	Marriage & Family Therapist		MFC21358	CALIFORNIA	No
2	101YM0800X	Counselor	Mental Health	MFC21358	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1922082726	OTHER	CALIFORNIA	STANISLAUS COUNTY BEHAVIORAL HEALTH AND RECOVERY SERVICES

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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