Organization
KAISER PERMANENTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STUART BUTTLAIRE PH. D. (DIRECTOR, INPATIENT SERVICES)
(925) 372-1103
Entity
Organization
Contact information
Practice address
200 MUIR RD, MARTINEZ, CA 94553-4614
(707) 558-8991
Mailing address
206 LA BREA ST, VALLEJO, CA 94591-8204
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LCS13038
CA
302R00000X
Health Maintenance Organization
Primary
LCS13038
CA
Other
Enumeration date
12/21/2006
Last updated
05/05/2021
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