Healthcare Provider Details

I. General information

NPI: 1053229229
Provider Name (Legal Business Name): FELICIA BETANCOURT
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1905 7TH ST
SANGER CA
93657-2806
US

IV. Provider business mailing address

1905 7TH ST
SANGER CA
93657-2806
US

V. Phone/Fax

Practice location:
  • Phone: 559-875-6521
  • Fax:
Mailing address:
  • Phone: 559-875-6521
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number7393
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: