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General NPI Number Information
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NPI Number | 1295347276
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Entity Type | Individual
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Provider Name | BEATRIZ BORJAS
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Gender | Female
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Dates
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Enumeration Date | 08/20/2020
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Last Update Date | 08/20/2020
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Provider Practice Location Address
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Address Line | 3820 MARTIN LUTHER KING JR BLVD
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City | LYNWOOD
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State | CA
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Zip | 90262-3625
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Country | US
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Telephone | 310-632-0145
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Fax |
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Provider Business Mailing Address
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Address Line | 11221 STATE ST
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City | LYNWOOD
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State | CA
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Zip | 90262-2440
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Country | US
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Telephone | 323-807-6965
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 253142
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License Number State | CA
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