Eddie James Bernal Jr.
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Venice, CA
NPI 1487242574 · NPPES record last updated Jan 5, 2021
Key facts
- NPI
- 1487242574
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- Practice address
- 503 Ocean Front Walk
Venice, CA 90291-2403 - Phone
- (866) 671-9392
- NPI assigned
- Jan 5, 2021
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | Yes |
Addresses
Primary practice location
503 Ocean Front Walk
Venice, CA 90291-2403
Mailing address
503 Ocean Front Walk
Venice, CA 90291-2403
Phone (888) 671-9392
Other providers in Venice, CA
- Christian Karlin( Bello
- Laura Elena Benjamin
- Kristal Diane Bent
- Olivia Rebecca Berman
- Estefania Bernabe
- Monica Judith Bernal
- Nicholas Matthew Bernthal
- Rudolfo J Berru
- Paula Betart
- Theresa Bierek
All providers in Venice, CA · Addiction (Substance Use Disorder) Counselor in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 5, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.