Provider Demographics
NPI:1770364036
Name:BECERRA, NATALYA ALEXIS
Entity type:Individual
Prefix:
First Name:NATALYA
Middle Name:ALEXIS
Last Name:BECERRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 NORWICH CT
Mailing Address - Street 2:
Mailing Address - City:BARSTOW
Mailing Address - State:CA
Mailing Address - Zip Code:92311-8606
Mailing Address - Country:US
Mailing Address - Phone:760-447-4364
Mailing Address - Fax:
Practice Address - Street 1:210 NORWICH CT
Practice Address - Street 2:
Practice Address - City:BARSTOW
Practice Address - State:CA
Practice Address - Zip Code:92311-8606
Practice Address - Country:US
Practice Address - Phone:760-447-4364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst