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NPI Code Detail

MEDICARE: VANCE B BECKER INC A PSYCHOLOGICAL CORPORATION

MEDICARE: VANCE B BECKER INC A PSYCHOLOGICAL CORPORATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1173000000XLegal Medicine001695CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11013912443OTHERCANPI

General Provider Information

NPI Number : 1083916621
Entity Type Code : Organization
Provider Name (Legal Business Name) : VANCE B BECKER INC A PSYCHOLOGICAL CORPORATION
Provider Business Mailing Address
First Line : 1451 QUAIL ST
Second Line : SUITE 102
City : NEWPORT BEACH
State : CA
Zip : 92660-2742
Country : US
Telephone Number : 949-757-1113
Fax Number :
Provider Business Practice Location Address
First Line : 1451 QUAIL ST
Second Line : SUITE 102
City : NEWPORT BEACH
State : CA
Zip : 92660-2742
Country : US
Telephone Number : 949-757-1113
Fax Number :
Authorized Official
Title or Position : CFO
Name : DR. JULIETTE BECKER
Credential : PH.D.
Telephone Number : 949-757-1113
Provider Enumeration Date : 12/02/2010
Last Update Date : 07/22/2016

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Directions to “VANCE B BECKER INC A PSYCHOLOGICAL CORPORATION ” Practice Location

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