Healthcare Provider Details

I. General information

NPI: 1841120508
Provider Name (Legal Business Name): JAN BEECH CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 N SAN MARINO AVE
SAN GABRIEL CA
91775-2912
US

IV. Provider business mailing address

2714 PHELPS AVE # 4
LOS ANGELES CA
90032-2746
US

V. Phone/Fax

Practice location:
  • Phone: 626-282-3926
  • Fax:
Mailing address:
  • Phone: 310-270-1262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number25341
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: