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General NPI Number Information
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NPI Number | 1982198230
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Entity Type | Individual
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Provider Name | BERNICE OGOLA PMHNP
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Gender | Female
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Dates
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Enumeration Date | 06/20/2018
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Last Update Date | 04/24/2025
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Provider Practice Location Address
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Address Line | 11518 N FRONTAGE RD
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City | YUMA
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State | AZ
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Zip | 85367-8994
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Country | US
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Telephone | 928-342-6500
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 669
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City | YUMA
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State | AZ
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Zip | 85366-2329
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Country | US
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Telephone | 520-476-3503
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 726556
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 320202
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License Number State | AZ
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