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General NPI Number Information
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NPI Number | 1639603251
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Entity Type | Individual
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Provider Name | GERMAN MINERO
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Gender | Male
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Dates
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Enumeration Date | 04/20/2017
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Last Update Date | 12/30/2024
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Provider Practice Location Address
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Address Line | 325 W HOSPITALITY LN
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City | SAN BERNARDINO
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State | CA
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Zip | 92408-3243
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Country | US
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Telephone | 866-205-3595
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Fax |
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Provider Business Mailing Address
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Address Line | 515 PLAYA DE CORTE
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City | PERRIS
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State | CA
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Zip | 92571-3426
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Country | US
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Telephone | 951-623-2637
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 126527
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License Number State | CA
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