Basic Information
| Provider Information | |||||||||
| NPI: | 1073139440 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BELTRAN | ||||||||
| FirstName: | PAULA | ||||||||
| MiddleName: | RUBY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1615 BUNKER HILL WAY STE 140 | ||||||||
| Address2: | |||||||||
| City: | SALINAS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939066010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8317961386 | ||||||||
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| Practice Location | |||||||||
| Address1: | 559 E ALISAL ST STE 201&202 | ||||||||
| Address2: | |||||||||
| City: | SALINAS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939052516 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8317698800 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/22/2020 | ||||||||
| LastUpdateDate: | 07/08/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/08/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171M00000X | Y | Other Service Providers | Case Manager/Care Coordinator | 374700000X | N | Nursing Service Related Providers | Technician |
No ID Information.