Provider Demographics
NPI:1295516938
Name:BEAMING HEALTHCARE GROUP, P.C.
Entity type:Organization
Organization Name:BEAMING HEALTHCARE GROUP, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DOMENIQUE
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:HENDERSHOT EMBREY
Authorized Official - Suffix:
Authorized Official - Credentials:OTD, MS OTR/L
Authorized Official - Phone:510-701-5990
Mailing Address - Street 1:484 HILLVIEW DR
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94536-2821
Mailing Address - Country:US
Mailing Address - Phone:510-701-5990
Mailing Address - Fax:
Practice Address - Street 1:2021 FILLMORE ST # 1367
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2708
Practice Address - Country:US
Practice Address - Phone:415-236-2178
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty