Mary Josephine Becerra, LD
Individual provider Active NPI Registered Dietitian · Tulsa, OK
NPI 1992776058 · NPPES record last updated Nov 28, 2011
Key facts
- NPI
- 1992776058
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 1355 (OK)
- Practice address
- 744 W 9TH St
Tulsa, OK 74127-9020 - Phone
- (918) 599-5744
- Fax
- (918) 599-1763
- NPI assigned
- Jan 27, 2006
- 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)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 1355 | OK | Yes |
Addresses
Primary practice location
744 W 9TH St
Tulsa, OK 74127-9020
Mailing address
744 W 9TH St
Tulsa, OK 74127-9020
Phone (918) 599-5744
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200054920A | Medicaid | OK |
Other names
- Mary Jo Vincent
Other providers in Tulsa, OK
- Greta Kay Beaver
- Kristi Beaver
- Rebecca Beaver
- Josh Jordan Beavers
- Kathryn Ann Beavers
- Ryan Matthew Beck
- Taylor Elizabeth Beck
- Kathy Becker
- Shelby Becker
- Madison Beckman
All providers in Tulsa, OK · Registered Dietitian in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 28, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.