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General NPI Number Information
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NPI Number | 1033769898
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Entity Type | Individual
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Provider Name | LORI BECKER
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Gender | Female
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Dates
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Enumeration Date | 09/13/2019
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Last Update Date | 09/13/2019
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Provider Practice Location Address
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Address Line | 12175 DOUGLAS ST
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City | YUCAIPA
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State | CA
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Zip | 92399-4428
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Country | US
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Telephone | 909-271-1071
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Fax |
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Provider Business Mailing Address
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Address Line | 177 SUMMIT VIEW DR
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City | CALIMESA
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State | CA
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Zip | 92320-1710
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Country | US
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Telephone | 909-744-7522
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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License Number State |
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