Individual
MS. ALFREDA YVONNE BANTUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
1505 W HIGHLAND AVE STE 17, SAN BERNARDINO, CA 92411-1215
(909) 880-9130
(909) 473-1918
Mailing address
20426 TOBIRA LN, RIVERSIDE, CA 92508-3030
(951) 756-9637
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
55644
CA
251S00000X
Community/Behavioral Health Agency
—
CA
Other
Enumeration date
04/25/2007
Last updated
03/15/2013
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