Provider Demographics
NPI:1831337690
Name:BECERRIL, NANCY
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:BECERRIL
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 1:1406 N AZUSA AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91722-1257
Mailing Address - Country:US
Mailing Address - Phone:626-858-9940
Mailing Address - Fax:626-858-9366
Practice Address - Street 1:1406 N AZUSA AVE
Practice Address - Street 2:SUITE C
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91722-1257
Practice Address - Country:US
Practice Address - Phone:626-858-9940
Practice Address - Fax:626-858-9366
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-30
Last Update Date:2009-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant