Healthcare Provider Details

I. General information

NPI: 1932176450
Provider Name (Legal Business Name): FRANK BEJARANO LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2006
Last Update Date: 02/01/2024
Certification Date: 01/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1852 N MASTICK WAY MARIPOSA COMMUNITY HEALTH CENTER
NOGALES AZ
85621-1063
US

IV. Provider business mailing address

371 VIA CAPRI
RIO RICO AZ
85648-1662
US

V. Phone/Fax

Practice location:
  • Phone: 520-281-1550
  • Fax: 520-281-1112
Mailing address:
  • Phone: 520-313-3476
  • Fax: 520-377-8279

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC11949
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: