Provider Demographics
NPI:1316016793
Name:BEECH, MARIE LOUISE (PSYD)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:LOUISE
Last Name:BEECH
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1873
Mailing Address - Street 2:
Mailing Address - City:DISCOVERY BAY
Mailing Address - State:CA
Mailing Address - Zip Code:94505-7873
Mailing Address - Country:US
Mailing Address - Phone:562-331-0978
Mailing Address - Fax:925-384-2372
Practice Address - Street 1:5655 SCHOONER LOOP
Practice Address - Street 2:
Practice Address - City:DISCOVERY BAY
Practice Address - State:CA
Practice Address - Zip Code:94505-9213
Practice Address - Country:US
Practice Address - Phone:562-331-0978
Practice Address - Fax:925-384-2372
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18338103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist