Provider Demographics
NPI:1669805222
Name:MACMASTER, DAVID BRIAN (MFTI)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:BRIAN
Last Name:MACMASTER
Suffix:
Gender:M
Credentials:MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2778 HAMPTON WAY
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-5570
Mailing Address - Country:US
Mailing Address - Phone:559-294-1714
Mailing Address - Fax:
Practice Address - Street 1:2778 HAMPTON WAY
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-5570
Practice Address - Country:US
Practice Address - Phone:559-294-1714
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-17
Last Update Date:2013-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63206101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health