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NPI Code Detail

MEDICARE: GUY BERCEGEAY

MEDICARE: GUY BERCEGEAY
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
1101YA0400XAddiction (Substance Use Disorder) Counselor
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1922750017
Entity Type Code : Individual
Provider Name (Legal Business Name) : GUY BERCEGEAY
Provider Business Mailing Address
First Line : 11015 BLOOMFIELD AVE
Second Line :
City : SANTA FE SPRINGS
State : CA
Zip : 90670-4601
Country : US
Telephone Number : 562-906-2676
Fax Number :
Provider Business Practice Location Address
First Line : 12580 LAKELAND RD
Second Line :
City : SANTA FE SPRINGS
State : CA
Zip : 90670-3940
Country : US
Telephone Number : 562-210-5751
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2022
Last Update Date : 12/19/2024

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Directions to “ GUY BERCEGEAY ” Practice Location

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