Healthcare Provider Details

I. General information

NPI: 1093365918
Provider Name (Legal Business Name): JAIMEE BECK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2019
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 2273
LA HABRA CA
90632-2273
US

IV. Provider business mailing address

PO BOX 2273
LA HABRA CA
90632-2273
US

V. Phone/Fax

Practice location:
  • Phone: 562-485-9309
  • Fax:
Mailing address:
  • Phone: 562-246-6108
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number17984
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: