Individual
BERNETTE SERRANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
205 PASADENA AVE, SOUTH PASADENA, CA 91030-2919
(323) 344-5536
Mailing address
205 PASADENA AVE, SOUTH PASADENA, CA 91030-2919
(323) 344-5536
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7184
MEDI-CAL
CA
01
—
7368
MEDI-CAL
CA
01
—
7667
MEDI-CAL
CA
01
—
7708
MEDI-CAL
CA
Enumeration date
08/27/2018
Last updated
08/27/2018
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