Individual
DR. BERENICE IBANEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
4004 BEYER BLVD, SAN YSIDRO, CA 92173-2007
(619) 428-5561
(619) 205-1979
Mailing address
4004 BEYER BLVD, SAN YSIDRO, CA 92173-2007
(619) 428-5561
(619) 205-1979
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY22080
CA
Other
Enumeration date
08/19/2006
Last updated
06/04/2012
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