Provider Demographics
NPI:1790938777
Name:D'CUNHA, BEVERLY ANN
Entity Type:Individual
Prefix:MISS
First Name:BEVERLY
Middle Name:ANN
Last Name:D'CUNHA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19801 VANOWEN ST STE H
Mailing Address - Street 2:
Mailing Address - City:WINNETKA
Mailing Address - State:CA
Mailing Address - Zip Code:91306-3962
Mailing Address - Country:US
Mailing Address - Phone:818-914-5077
Mailing Address - Fax:818-483-8428
Practice Address - Street 1:19801 VANOWEN ST STE H
Practice Address - Street 2:
Practice Address - City:WINNETKA
Practice Address - State:CA
Practice Address - Zip Code:91306-3962
Practice Address - Country:US
Practice Address - Phone:818-914-5077
Practice Address - Fax:818-483-8428
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-04
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU2658237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB0546ZMedicare PIN