Basic Information
| Provider Information | |||||||||
| NPI: | 1518076413 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BEATON | ||||||||
| FirstName: | CLEOPATRA | ||||||||
| MiddleName: | AQUINO | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | RN, NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 26857 COLD SPRINGS ST | ||||||||
| Address2: | |||||||||
| City: | AGOURA HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913015307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3104783711 | ||||||||
| FaxNumber: | 3102684250 | ||||||||
| Practice Location | |||||||||
| Address1: | 11301 WILSHIRE BLVD # 111-J | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900731003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3104783711 | ||||||||
| FaxNumber: | 3102684250 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN395919 | CA | X | Nursing Service Providers | Registered Nurse | 363LA2200X | RN395919 | CA | X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.