Provider Demographics
NPI:1871527051
Name:BUTCHER, RALPH ROBERT (MS, MFT)
Entity type:Individual
Prefix:MR
First Name:RALPH
Middle Name:ROBERT
Last Name:BUTCHER
Suffix:
Gender:M
Credentials:MS, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2182 BRANDYWINE PL
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94542-1145
Mailing Address - Country:US
Mailing Address - Phone:510-581-9975
Mailing Address - Fax:925-855-1152
Practice Address - Street 1:12 CROW CANYON CT
Practice Address - Street 2:SUITE 210
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-1975
Practice Address - Country:US
Practice Address - Phone:925-855-1007
Practice Address - Fax:925-855-1152
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC39851106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist