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General NPI Number Information
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NPI Number | 1043714504
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Entity Type | Individual
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Provider Name | EGIYAH BEVERLY
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Gender | Female
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Dates
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Enumeration Date | 03/20/2018
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 800 N 1ST ST FL 2
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City | SAN JOSE
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State | CA
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Zip | 95112-6312
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Country | US
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Telephone | 925-266-8400
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Fax |
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Provider Business Mailing Address
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Address Line | 2730 SHADELANDS DR BLDG 10
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City | WALNUT CREEK
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State | CA
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Zip | 94598-2538
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Country | US
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Telephone |
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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 | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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