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NPI Code Detail

MEDICARE: BRENDA BULNES-GERARDO MFT

MEDICARE: BRENDA BULNES-GERARDO MFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
2106H00000XMarriage & Family TherapistLMFT52875CA

General Provider Information

NPI Number : 1396987319
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRENDA BULNES-GERARDO MFT
Provider Business Mailing Address
First Line : 2275 ARLINGTON DR
Second Line :
City : SAN LEANDRO
State : CA
Zip : 94578-1132
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 233 S QUINTANA DR
Second Line :
City : ANAHEIM
State : CA
Zip : 92807-4029
Country : US
Telephone Number : 714-998-9814
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2009
Last Update Date : 09/21/2018

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