Provider Demographics
NPI:1689138455
Name:BEAUVOIR, ARIELLE (ATC, PSYCH ASSOC)
Entity type:Individual
Prefix:
First Name:ARIELLE
Middle Name:
Last Name:BEAUVOIR
Suffix:
Gender:F
Credentials:ATC, PSYCH ASSOC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:940 VERNON AVE
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:CA
Mailing Address - Zip Code:90291-2839
Mailing Address - Country:US
Mailing Address - Phone:650-438-4317
Mailing Address - Fax:
Practice Address - Street 1:10323 SANTA MONICA BLVD STE 102
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-5056
Practice Address - Country:US
Practice Address - Phone:424-421-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-25
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer