Provider Demographics
NPI:1528468410
Name:BEEHN, DOLORES
Entity type:Individual
Prefix:
First Name:DOLORES
Middle Name:
Last Name:BEEHN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2324 AYERS AVE
Mailing Address - Street 2:
Mailing Address - City:COMMERCE
Mailing Address - State:CA
Mailing Address - Zip Code:90040-1007
Mailing Address - Country:US
Mailing Address - Phone:650-270-3076
Mailing Address - Fax:
Practice Address - Street 1:9436 SLAUSON AVE
Practice Address - Street 2:
Practice Address - City:PICO RIVERA
Practice Address - State:CA
Practice Address - Zip Code:90660-4748
Practice Address - Country:US
Practice Address - Phone:562-942-3230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-27
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator