Active NPI
Stacey Leeanne Beckman
- Social Worker
- Perris, CA
National Provider Identifier
1164200069
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 450 E San Jacinto Ave
Perris, CA 92571-2833 - Phone
- (800) 720-9553
- NPI assigned
- Sep 20, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
450 E San Jacinto Ave
Perris, CA 92571-2833
Mailing address
4095 County Circle Dr
Riverside, CA 92503-3410
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ASW86446 | Other | CA | BOARD OF BEHAVIORAL SCIENCES |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700524800000",
"number": "1164200069",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4095 COUNTY CIRCLE DR",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925033410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450 E SAN JACINTO AVE",
"city": "PERRIS",
"state": "CA",
"postal_code": "925712833",
"telephone_number": "800-720-9553"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BECKMAN",
"first_name": "STACEY",
"middle_name": "LEEANNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-20",
"last_updated": "2023-11-21",
"certification_date": "2023-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF BEHAVIORAL SCIENCES",
"identifier": "ASW86446",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Perris, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.