Becerra, Luis Antonio

Becerra, Luis Antonio is an sole proprietor health care provider with primary practice located at 525 Cabrillo Park Dr Ste 300 , Santa Ana CA 92701. He recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Counselor, Behavioral Health & Social Service Providers / Clinical Child & Adolescent. Behavioral Health & Social Service Providers / Clinical Child & Adolescent is his primary health care specialty. Becerra, Luis Antonio can be contacted via phone (714) 953-4455.

Contact Information

Primary practice address
525 Cabrillo Park Dr Ste 300 Santa Ana CA 92701
Phone: (714) 953-4455
Fax: (714) 542-2793
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Counselor 225C00000X
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X

Profile Details

NPI number 1902155997
LBN Legal business name Becerra, Luis Antonio
Credentials PSYD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 5th, 2012
Last updated Jan 3rd, 2019 - about 7 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 1902155997 NPPES
California MEDICAID 7068
California MEDICAID 7420

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