Provider Demographics
NPI:1104602457
Name:NAVARRO, BE-VERLYN (NP)
Entity type:Individual
Prefix:
First Name:BE-VERLYN
Middle Name:
Last Name:NAVARRO
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5167 CLAYTON RD STE H
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94521-3170
Mailing Address - Country:US
Mailing Address - Phone:323-336-1178
Mailing Address - Fax:
Practice Address - Street 1:5167 CLAYTON RD STE H
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94521-3170
Practice Address - Country:US
Practice Address - Phone:323-336-1178
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-04
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA750877163W00000X
CA95026583363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse