Healthcare Provider Details
I. General information
NPI: 1033277033
Provider Name (Legal Business Name): BEATA ALINA PEARCE MSN, FNP, PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/04/2006
Last Update Date: 08/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1436 GOODRICH BLVD
COMMERCE CA
90022-5111
US
IV. Provider business mailing address
PO BOX 3957
HUNTINGTON BEACH CA
92605-3957
US
V. Phone/Fax
- Phone: 323-725-1337
- Fax:
- Phone: 714-421-3825
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 95000416 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | 2018019669 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: