Healthcare Provider Details

I. General information

NPI: 1174359525
Provider Name (Legal Business Name): BAY AREA NURSING SELF CARE BY BETH CASTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2024
Last Update Date: 09/11/2024
Certification Date: 09/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

603 MOANA WAY
PACIFICA CA
94044-2841
US

IV. Provider business mailing address

603 MOANA WAY
PACIFICA CA
94044-2841
US

V. Phone/Fax

Practice location:
  • Phone: 619-339-1314
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: BETH CASTER
Title or Position: PRESIDENT & CEO
Credential:
Phone: 619-339-1314