Healthcare Provider Details

I. General information

NPI: 1518076413
Provider Name (Legal Business Name): CLEOPATRA AQUINO BEATON RN, NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11301 WILSHIRE BLVD # 111-J
LOS ANGELES CA
90073-1003
US

IV. Provider business mailing address

26857 COLD SPRINGS ST
AGOURA HILLS CA
91301-5307
US

V. Phone/Fax

Practice location:
  • Phone: 310-478-3711
  • Fax: 310-268-4250
Mailing address:
  • Phone: 310-478-3711
  • Fax: 310-268-4250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberRN395919
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN395919
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: