Provider Demographics
NPI:1235129032
Name:MCGUIRE, BETH ANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:BETH
Middle Name:ANN
Last Name:MCGUIRE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 W CITRUS AVE
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-4625
Mailing Address - Country:US
Mailing Address - Phone:909-793-7064
Mailing Address - Fax:909-793-9485
Practice Address - Street 1:521 W CITRUS AVE
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-4625
Practice Address - Country:US
Practice Address - Phone:909-793-7064
Practice Address - Fax:909-793-9485
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-24
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY10520103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0PL105200Medicare UPIN