Healthcare Provider Details

I. General information

NPI: 1972860914
Provider Name (Legal Business Name): MAUVA JOAN BEHARIE N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2012
Last Update Date: 04/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10050 GARVEY, SUITE111
EL MONTE CA
91731
US

IV. Provider business mailing address

101 OAK GROVE
MONROVIA CA
91016
US

V. Phone/Fax

Practice location:
  • Phone: 626-652-0790
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP1700X
TaxonomyPerinatal Nurse Practitioner
License Number654511
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number654511
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number654511
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: