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General NPI Number Information
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NPI Number | 1699031690
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Entity Type | Individual
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Provider Name | MR. DANE ROHAN BECKFORD
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Gender | Male
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Dates
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Enumeration Date | 04/04/2012
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Last Update Date | 12/10/2013
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Provider Practice Location Address
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Address Line | 9500 ETIWANDA AVE
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91739-9662
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Country | US
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Telephone | 909-463-5000
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Fax | 909-463-5295
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Provider Business Mailing Address
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Address Line | 1950 S. SUNWEST LANE
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City | SAN BERNARDINO
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State | CA
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Zip | 92415
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Country | US
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Telephone | 909-252-4010
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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