Healthcare Provider Details

I. General information

NPI: 1255534186
Provider Name (Legal Business Name): MEGAHN M BECK M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2007
Last Update Date: 01/03/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5755 COTTLE RD BUILDING 1
SAN JOSE CA
95123-3640
US

IV. Provider business mailing address

1050 BENTON ST APT. 2314
SANTA CLARA CA
95050-4854
US

V. Phone/Fax

Practice location:
  • Phone: 408-972-3311
  • Fax:
Mailing address:
  • Phone: 612-396-8549
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: