Provider Demographics
NPI:1912579137
Name:BECKER, ELIZABETH LOUISE
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:LOUISE
Last Name:BECKER
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 1:9822 ARAPAHO ST
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91977-5203
Mailing Address - Country:US
Mailing Address - Phone:619-987-9948
Mailing Address - Fax:
Practice Address - Street 1:9822 ARAPAHO ST
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91977-5203
Practice Address - Country:US
Practice Address - Phone:619-987-9948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-15
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic