| Doctor Name: | DR. TIMOTHY MARK BEACH |
| NPI Number: | 1427397702 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PSY. D. |
| License Number: | 22544 |
| Business Practice Address: | 21633 Avenue 24 Chowchilla, CA - 936109650 |
| Business Phone Number: | 5596656100 |
| Business Fax Number: | |
| Mailing Address: | Po Box 99, CHOWCHILLA |
| State: | CA |
| Postal Code: | 936100099 |
| Phone Number: | 5596656100 |
| Fax Number: | |
| NPI Enumeration Date: | 02/06/2013 |
| NPI Last Update Date: | 02/06/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 22544 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |