Healthcare Provider Details

I. General information

NPI: 1730458837
Provider Name (Legal Business Name): PATRICIA JANE BECKWITH M.F.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2011
Last Update Date: 12/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9137 LA PORTE RD
BROWNSVILLE CA
95919-9710
US

IV. Provider business mailing address

PO BOX 141
CHALLENGE CA
95925-0141
US

V. Phone/Fax

Practice location:
  • Phone: 530-675-9517
  • Fax:
Mailing address:
  • Phone: 530-675-9517
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC 44537
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: