Provider Demographics
NPI:1740627314
Name:BESCOBY, GRACE LABIANO (RN)
Entity type:Individual
Prefix:MRS
First Name:GRACE
Middle Name:LABIANO
Last Name:BESCOBY
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3205 N LAKEWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90808-1733
Mailing Address - Country:US
Mailing Address - Phone:213-304-1304
Mailing Address - Fax:
Practice Address - Street 1:3205 N LAKEWOOD BLVD
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90808-1733
Practice Address - Country:US
Practice Address - Phone:213-304-1304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-23
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA512560101YM0800X, 163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health