Individual
RUTH MICHELLE BEAUCAGE-PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4441 KITTIWAKE WAY, OCEANSIDE, CA 92057-7727
(760) 485-7079
Mailing address
255 HYACINTH WAY, OCEANSIDE, CA 92057-6648
(859) 496-0419
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W2115004
DRIVER LICENSE
CA
Enumeration date
10/30/2023
Last updated
10/30/2023
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