MEDICARE: DR. MARGOT T BEATTIE

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
1	103TP0814X	Psychoanalysis Psychologist	PSY10550	CA

General Provider Information

NPI Number	:	1306464573
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARGOT T BEATTIE

Provider Business Mailing Address
First Line	:	7800 EUREKA AVE
Second Line	:
City	:	EL CERRITO
State	:	CA
Zip	:	94530-3305
Country	:	US
Telephone Number	:	510-387-1520
Fax Number	:

Provider Business Practice Location Address
First Line	:	2000 HEARST AVE STE 208
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94709-2260
Country	:	US
Telephone Number	:	510-387-1520
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2020
Last Update Date	:	07/13/2020

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