Provider Demographics
NPI:1245963180
Name:BEARD, VERONICA GARCIA (NP)
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:GARCIA
Last Name:BEARD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 E ORANGEBURG AVE STE 675-212
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355-3351
Mailing Address - Country:US
Mailing Address - Phone:209-661-4178
Mailing Address - Fax:
Practice Address - Street 1:111 WRIGHT ST
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95354-0553
Practice Address - Country:US
Practice Address - Phone:209-661-4178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-07
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95017943363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner