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General NPI Number Information
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NPI Number | 1811265721
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Entity Type | Individual
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Provider Name | JACQUALINE BECK LCSW
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Gender | Female
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Dates
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Enumeration Date | 12/06/2011
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Last Update Date | 12/06/2011
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Provider Practice Location Address
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Address Line | 4801 J ST STE E
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City | SACRAMENTO
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State | CA
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Zip | 95819-3746
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Country | US
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Telephone | 916-456-4624
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Fax |
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Provider Business Mailing Address
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Address Line | 1940 MAMMOTH WAY
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City | SACRAMENTO
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State | CA
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Zip | 95834-2802
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Country | US
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Telephone | 916-837-8960
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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 | LCS 25323
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License Number State | CA
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