Healthcare Provider Details

I. General information

NPI: 1033449475
Provider Name (Legal Business Name): MARA NEWMAN BECK M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2010
Last Update Date: 01/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7111 SHADOW RIDGE CT
WEST HILLS CA
91307-3821
US

IV. Provider business mailing address

7111 SHADOW RIDGE CT
WEST HILLS CA
91307-3821
US

V. Phone/Fax

Practice location:
  • Phone: 310-701-8315
  • Fax:
Mailing address:
  • Phone: 310-701-8315
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP9886
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: