Provider Demographics
NPI:1356687909
Name:BECKWITH, JOHN
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:
Last Name:BECKWITH
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:JOHN
Other - Middle Name:
Other - Last Name:BECKWITH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:HAD
Mailing Address - Street 1:114 ROYCE ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95030-6040
Mailing Address - Country:US
Mailing Address - Phone:408-827-4110
Mailing Address - Fax:
Practice Address - Street 1:114 ROYCE ST
Practice Address - Street 2:SUITE D
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95030-6040
Practice Address - Country:US
Practice Address - Phone:408-827-4110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-28
Last Update Date:2012-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7606237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist