Healthcare Provider Details

I. General information

NPI: 1598649931
Provider Name (Legal Business Name): MARADITH BECK FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2025
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

752 FOREST PARK BLVD APT 204
OXNARD CA
93036-5423
US

IV. Provider business mailing address

752 FOREST PARK BLVD APT 204
OXNARD CA
93036-5423
US

V. Phone/Fax

Practice location:
  • Phone: 443-812-6966
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95036007
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95215909
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: