NPI Code Details Logo

NPI 1093470619

NPI 1093470619 : ELIZABETH AGUSTI BECERRA : RIVERSIDE, CA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1093470619
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    ELIZABETH AGUSTI BECERRA
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    11/08/2021
-----------------------------------------------------
    Last Update Date     |    11/21/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    6800 INDIANA AVE STE 150 
-----------------------------------------------------
    City                 |    RIVERSIDE
-----------------------------------------------------
    State                |    CA
-----------------------------------------------------
    Zip                  |    92506-4286
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    951-616-4076
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    6800 INDIANA AVE STE 150 
-----------------------------------------------------
    City                 |    RIVERSIDE
-----------------------------------------------------
    State                |    CA
-----------------------------------------------------
    Zip                  |    92506-4286
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    909-243-1753
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    106H00000X
-----------------------------------------------------
    Taxonomy Name        |    Marriage & Family Therapist
-----------------------------------------------------
    License Number       |    142541
-----------------------------------------------------
    License Number State |    CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    106H00000X
-----------------------------------------------------
    Taxonomy Name        |    Marriage & Family Therapist
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.