Provider Demographics
NPI:1114351954
Name:GARCIA-BECKER, DIANE INEZ
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:INEZ
Last Name:GARCIA-BECKER
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 1:9075 SVL BOX
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92395-5146
Mailing Address - Country:US
Mailing Address - Phone:760-486-5959
Mailing Address - Fax:
Practice Address - Street 1:9075 SVL BOX
Practice Address - Street 2:12905 ROLLING RIDGE DRIVE
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-5146
Practice Address - Country:US
Practice Address - Phone:760-486-5959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-28
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health