Provider Demographics
NPI:1376981704
Name:BECKERT, DEBRA WILLIAMS (REGISTERED NURESE)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:WILLIAMS
Last Name:BECKERT
Suffix:
Gender:F
Credentials:REGISTERED NURESE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2105 SILVERADO DR
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-5843
Mailing Address - Country:US
Mailing Address - Phone:925-584-1915
Mailing Address - Fax:925-754-3401
Practice Address - Street 1:1340 ARNOLD DRIVE
Practice Address - Street 2:SUITE 200
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-5843
Practice Address - Country:US
Practice Address - Phone:925-584-1915
Practice Address - Fax:925-754-3401
Is Sole Proprietor?:No
Enumeration Date:2013-06-07
Last Update Date:2013-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA416178163WC0400X, 163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No163WC0400XNursing Service ProvidersRegistered NurseCase Management