Latina Beckett

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Duarte, CA

NPI 1962012518 · NPPES record last updated Aug 7, 2020

Key facts

NPI
1962012518
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
2335 Mountain Ave
Duarte, CA 91010-3559
Phone
(818) 821-6012
Fax
(818) 821-6014
NPI assigned
Aug 7, 2020
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

2335 Mountain Ave
Duarte, CA 91010-3559

Mailing address

12501 Chandler Blvd Ste 102
Valley Village, CA 91607-1955
Phone (818) 821-6012

Other providers in Duarte, CA

All providers in Duarte, CA · Student in an Organized Health Care Education/Training Program in California

Sources for this page

Verify at the official NPI Registry.