Provider Demographics
NPI:1689604431
Name:FRANK, BEVERLY B (PSYD)
Entity Type:Individual
Prefix:DR
First Name:BEVERLY
Middle Name:B
Last Name:FRANK
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3105 YALE AVE
Mailing Address - Street 2:
Mailing Address - City:MARINA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90292-5540
Mailing Address - Country:US
Mailing Address - Phone:310-301-0985
Mailing Address - Fax:310-822-4089
Practice Address - Street 1:3105 YALE AVE
Practice Address - Street 2:
Practice Address - City:MARINA DEL REY
Practice Address - State:CA
Practice Address - Zip Code:90292-5540
Practice Address - Country:US
Practice Address - Phone:310-301-0985
Practice Address - Fax:310-822-4089
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 12919103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist