Provider Demographics
NPI:1215084462
Name:AURIOLES, BETHANY LE (LPT)
Entity type:Individual
Prefix:MRS
First Name:BETHANY
Middle Name:LE
Last Name:AURIOLES
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
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Mailing Address - Street 1:117 W TUNNELL ST
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93458-4037
Mailing Address - Country:US
Mailing Address - Phone:805-739-8670
Mailing Address - Fax:805-739-8671
Practice Address - Street 1:2975 MCMILLAN AVE STE 164
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-6768
Practice Address - Country:US
Practice Address - Phone:805-439-4890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT31188167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician