Provider Demographics
NPI:1255097515
Name:BECERRA, ANGEL FRANCISCO
Entity type:Individual
Prefix:
First Name:ANGEL
Middle Name:FRANCISCO
Last Name:BECERRA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 E WASHINGTON ST APT 204
Mailing Address - Street 2:
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324-8137
Mailing Address - Country:US
Mailing Address - Phone:562-298-9567
Mailing Address - Fax:
Practice Address - Street 1:901 E WASHINGTON ST APT 204
Practice Address - Street 2:
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324-8137
Practice Address - Country:US
Practice Address - Phone:562-298-9567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-11
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician