Provider Demographics
NPI:1346464054
Name:BECK, RONA LEE (PT)
Entity Type:Individual
Prefix:MRS
First Name:RONA
Middle Name:LEE
Last Name:BECK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2197 BROOKHILL DR
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-2107
Mailing Address - Country:US
Mailing Address - Phone:757-752-4821
Mailing Address - Fax:
Practice Address - Street 1:1901 OUTLET CENTER DR
Practice Address - Street 2:SUITE 110
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-0663
Practice Address - Country:US
Practice Address - Phone:805-981-9797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36289225100000X
VA2305005871171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No171W00000XOther Service ProvidersContractor