Provider Demographics
NPI:1104024678
Name:BELTRAN, ROBERTA ANNETTE
Entity Type:Individual
Prefix:MS
First Name:ROBERTA
Middle Name:ANNETTE
Last Name:BELTRAN
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 1:311 EAST AVENUE K-4
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93535
Mailing Address - Country:US
Mailing Address - Phone:661-726-5500
Mailing Address - Fax:
Practice Address - Street 1:311 EAST AVENUE K-4
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93535
Practice Address - Country:US
Practice Address - Phone:661-726-5500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health