=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588589055
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BCG DYNAMICS, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/12/2026
-----------------------------------------------------
Last Update Date | 08/12/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9252 IVES ST
-----------------------------------------------------
City | BELLFLOWER
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90706-3516
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 562-455-7981
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9252 IVES ST
-----------------------------------------------------
City | BELLFLOWER
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90706-3516
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 562-455-7981
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER
-----------------------------------------------------
Name | BERENICE G CRISTERNA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 562-455-7981
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 320600000X
-----------------------------------------------------
Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------