Provider Demographics
NPI:1073048674
Name:BECK, CARMEN (PHD, BCBA-D)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:
Last Name:BECK
Suffix:
Gender:F
Credentials:PHD, BCBA-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40960 CALIFORNIA OAKS RD UNIT 838
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-5747
Mailing Address - Country:US
Mailing Address - Phone:951-719-7050
Mailing Address - Fax:
Practice Address - Street 1:2108 N ST STE 4119
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-5712
Practice Address - Country:US
Practice Address - Phone:951-719-7050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-21
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-17-25773103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1942603162OtherNPI EMPLOYER NUMBER