Healthcare Provider Details

I. General information

NPI: 1871405621
Provider Name (Legal Business Name): ANNA BEATON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

670 PLACERVILLE DR STE 1D
PLACERVILLE CA
95667-4200
US

IV. Provider business mailing address

211 TILLMAN CT
EL DORADO HILLS CA
95762-9571
US

V. Phone/Fax

Practice location:
  • Phone: 530-622-5551
  • Fax:
Mailing address:
  • Phone: 530-344-4849
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number164950
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: