Provider Demographics
NPI:1699476689
Name:BELTRAN, NORA
Entity type:Individual
Prefix:
First Name:NORA
Middle Name:
Last Name:BELTRAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1535 S D ST
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92408-3253
Mailing Address - Country:US
Mailing Address - Phone:909-884-3735
Mailing Address - Fax:
Practice Address - Street 1:931 W. HOLT BLVD.
Practice Address - Street 2:SUITE #14
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91762-3676
Practice Address - Country:US
Practice Address - Phone:323-420-6765
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-15
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker