Healthcare Provider Details

I. General information

NPI: 1790938777
Provider Name (Legal Business Name): MISS BEVERLY ANN D'CUNHA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/04/2008
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21201 VICTORY BLVD STE 115
CANOGA PARK CA
91303-2830
US

IV. Provider business mailing address

21201 VICTORY BLVD STE 115
CANOGA PARK CA
91303-2830
US

V. Phone/Fax

Practice location:
  • Phone: 818-914-5077
  • Fax: 818-483-8428
Mailing address:
  • Phone: 818-914-5077
  • Fax: 818-483-8428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberAU2658
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: