Provider Demographics
NPI:1942435995
Name:CHAPMAN, BETH ANN (RPT)
Entity type:Individual
Prefix:MS
First Name:BETH
Middle Name:ANN
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:ANN
Other - Last Name:CHAPMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:1822 ROSEGLEN AVE
Mailing Address - Street 2:
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:90731-1171
Mailing Address - Country:US
Mailing Address - Phone:310-831-4871
Mailing Address - Fax:
Practice Address - Street 1:1 CIVIC PLAZA DRIVE
Practice Address - Street 2:
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90745
Practice Address - Country:US
Practice Address - Phone:866-414-0448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-20
Last Update Date:2009-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 13459225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist