Individual provider · Type 1 NPI

Elizabeth Angela Fayth Bettencourt

Student in an Organized Health Care Education/Training Program · Stockton, CA

NPI number 1609693241 Active

Practice location

430 N Pilgrim St
Stockton, CA 95205-4428

Call (209) 466-0853 Map

Mailing address

612 E Magnolia St
Stockton, CA 95202-1846

Specialties and licenses

TaxonomyCodeLicense
Community Health Worker 172V00000XNone listed
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1609693241

Elizabeth Angela Fayth Bettencourt's National Provider Identifier is 1609693241, issued on Sep 24, 2024. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Stockton, CA. The record was last updated on Oct 1, 2024.