Provider Demographics
NPI:1477685725
Name:BELTRAN, JOANNA ROSALVA (B A)
Entity Type:Individual
Prefix:MRS
First Name:JOANNA
Middle Name:ROSALVA
Last Name:BELTRAN
Suffix:
Gender:F
Credentials:B A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3162 MISSOURI AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH GATE
Mailing Address - State:CA
Mailing Address - Zip Code:90280-4155
Mailing Address - Country:US
Mailing Address - Phone:310-603-1030
Mailing Address - Fax:310-603-1377
Practice Address - Street 1:161 W VICTORIA ST
Practice Address - Street 2:SUITE 255
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90805-2175
Practice Address - Country:US
Practice Address - Phone:310-603-1030
Practice Address - Fax:310-603-1377
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health