Provider Demographics
NPI:1548421464
Name:BYRD, BEVERLY ANN (NP/RN)
Entity Type:Individual
Prefix:MS
First Name:BEVERLY
Middle Name:ANN
Last Name:BYRD
Suffix:
Gender:F
Credentials:NP/RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:17828 PIRES AVE
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-8722
Mailing Address - Country:US
Mailing Address - Phone:562-926-4067
Mailing Address - Fax:562-926-4067
Practice Address - Street 1:3634 ELIZABETH ST
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-2506
Practice Address - Country:US
Practice Address - Phone:951-341-8935
Practice Address - Fax:951-341-8932
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-23
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA432327163WP0808X
CA12641363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health