Provider Demographics
NPI:1205990942
Name:BECKNER, VICTORIA LEMLE (PHD)
Entity type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:LEMLE
Last Name:BECKNER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1777 UNION ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94123-4426
Mailing Address - Country:US
Mailing Address - Phone:415-845-4414
Mailing Address - Fax:415-381-5489
Practice Address - Street 1:1777 UNION ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94123-4426
Practice Address - Country:US
Practice Address - Phone:415-845-4414
Practice Address - Fax:415-381-5489
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2009-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY20789103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical