MEDICARE: MARY BRIDGET BEEMAN

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	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1427826262
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY BRIDGET BEEMAN

Provider Business Mailing Address
First Line	:	2623 ANTONIO DR UNIT 107
Second Line	:
City	:	CAMARILLO
State	:	CA
Zip	:	93010-1447
Country	:	US
Telephone Number	:	805-914-3072
Fax Number	:

Provider Business Practice Location Address
First Line	:	2623 ANTONIO DR UNIT 107
Second Line	:
City	:	CAMARILLO
State	:	CA
Zip	:	93010-1447
Country	:	US
Telephone Number	:	805-914-3072
Fax Number	:

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

Provider Enumeration Date	:	12/12/2023
Last Update Date	:	12/12/2023

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