Koerner, Beverly Ann

Koerner, Beverly Ann is an individual health care provider with primary practice located at 1400 Emeline Avenue , Santa Cruz CA 95060-1976. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Koerner, Beverly Ann can be contacted via phone (831) 454-4170.

Contact Information

Primary practice address
1400 Emeline Avenue Santa Cruz CA 95060-1976
Phone: (831) 454-4170
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X LCS21464 California

Profile Details

NPI number 1376756916
LBN Legal business name Koerner, Beverly Ann
Credentials LCS
Entity Individual
Sole proprietor 1 No
Enumeration date May 8th, 2007
Last updated Aug 30th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376756916 NPPES
California Other ZZZ92069Z MEDICARE GROUP ID#
California Other LCS 21464 MEDICARE GROUP ID#

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