Most Relevant Information
Provider Data
| NPI Number: | 1003648130 |
| Provider Name: | BRUCE EDWARD BECKER PPS,LEP |
| Entity Type: | Individual |
| Taxonomy Code: | 103T00000X |
| Specialty: | Psychologist |
| License Number: | 2529 |
Most Important Dates
| Enumeration Date: | 08/16/2024 |
| Last Updated: | 08/16/2024 |
Provider Practice Location
1305 E VINE ST
LODI
CA
952403179
Practice Location Phone/Fax
| Phone: | 2099152753 |
| Fax: |
Provider Mailing Location
1305 E VINE ST
LODI
CA
952403179
Provider Mailing Phone/Fax
| Phone: | 2099152753 |
| Fax: |