Provider Demographics
NPI:1326818311
Name:BEESON, SAMANTHA JOYCE (NP)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:JOYCE
Last Name:BEESON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40404 CALIFORNIA OAKS RD STE C
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-5786
Mailing Address - Country:US
Mailing Address - Phone:951-600-0288
Mailing Address - Fax:888-818-3162
Practice Address - Street 1:40404 CALIFORNIA OAKS RD STE C
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-5786
Practice Address - Country:US
Practice Address - Phone:951-600-0288
Practice Address - Fax:888-818-3162
Is Sole Proprietor?:No
Enumeration Date:2024-01-02
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95028516363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner