MEDICARE: ANABEL BEJARANO PHD

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
1	103T00000X	Psychologist	PSY 20333	CA

General Provider Information

NPI Number	:	1982794327
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANABEL BEJARANO PHD

Provider Business Mailing Address
First Line	:	5252 BALBOA AVE
Second Line	:	SUITE 209
City	:	SAN DIEGO
State	:	CA
Zip	:	92117-6906
Country	:	US
Telephone Number	:	619-410-5545
Fax Number	:	858-874-2944

Provider Business Practice Location Address
First Line	:	5252 BALBOA AVE
Second Line	:	SUITE 209
City	:	SAN DIEGO
State	:	CA
Zip	:	92117-6906
Country	:	US
Telephone Number	:	619-410-5545
Fax Number	:	858-874-2944

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/14/2006
Last Update Date	:	01/23/2008

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