Individual
DESTINY MARAE BEARDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1234 EMPIRE ST, FAIRFIELD, CA 94533-5711
(707) 429-4440
Mailing address
1234 EMPIRE ST, FAIRFIELD, CA 94533-5711
(707) 429-4440
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
101Y00000X
CA
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
01/12/2023
Last updated
05/17/2023
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