Provider Demographics
NPI:1326051335
Name:BECKER, MERI KATHRYN (DPT)
Entity Type:Individual
Prefix:
First Name:MERI
Middle Name:KATHRYN
Last Name:BECKER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1333 N MOUNTAIN AVE
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-3436
Mailing Address - Country:US
Mailing Address - Phone:626-918-6655
Mailing Address - Fax:
Practice Address - Street 1:1333 N MOUNTAIN AVE
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-3436
Practice Address - Country:US
Practice Address - Phone:626-918-6655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 24417225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT24417AMedicare ID - Type Unspecified