Individual
JOHANNA BERMUDEZ VERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2810 CAMINO DEL RIO S STE 102, SAN DIEGO, CA 92108-3819
(619) 299-1419
Mailing address
600 B ST STE 1570, SAN DIEGO, CA 92101-4560
(619) 615-0439
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
95119476
CA
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
95119476
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95017611
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/07/2018
Last updated
09/20/2021
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