Provider Demographics
NPI:1467950352
Name:ARREOLA BECERRA, BRYAN URIEL I
Entity Type:Individual
Prefix:
First Name:BRYAN
Middle Name:URIEL
Last Name:ARREOLA BECERRA
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 PENNSYLVANIA AVE SE APT 624
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-0458
Mailing Address - Country:US
Mailing Address - Phone:415-238-5142
Mailing Address - Fax:
Practice Address - Street 1:1380 HOWARD ST RM 130
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-2638
Practice Address - Country:US
Practice Address - Phone:415-255-3703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-25
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker