Provider Demographics
NPI:1669825568
Name:BEAUDOIN, MEAGHAN FRANCES (ATC)
Entity Type:Individual
Prefix:
First Name:MEAGHAN
Middle Name:FRANCES
Last Name:BEAUDOIN
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 AMETHYST AVE
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92662-1238
Mailing Address - Country:US
Mailing Address - Phone:805-207-0454
Mailing Address - Fax:
Practice Address - Street 1:20402 NEWPORT COAST DR
Practice Address - Street 2:
Practice Address - City:NEWPORT COAST
Practice Address - State:CA
Practice Address - Zip Code:92657-0300
Practice Address - Country:US
Practice Address - Phone:949-270-2349
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-15
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer