Johanna Bermudez Vera

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95017611 Issued in CA

Practice address

2810 Camino del Rio S Ste 102
San Diego, CA 92108-3819

Phone

(619) 299-1419

NPI assigned

Nov 7, 2018

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mental Health Systems, Inc.

  • Community/Behavioral Health Agency
  • San Diego, CA
  • NPI 1760431670
  Medicare reassignment NPD
• Mental Health Systems, Inc.

  • Community/Behavioral Health Agency
  • Fresno, CA
  • NPI 1720745169
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1541548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632096000000",
    "number": "1639647647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 B ST STE 1570",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921014560",
            "telephone_number": "619-615-0439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 CAMINO DEL RIO S STE 102",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083819",
            "telephone_number": "619-299-1419"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "140 Arbor Dr",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921032007",
            "country_code": "US",
            "telephone_number": "760-798-5602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERMUDEZ VERA",
        "first_name": "JOHANNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-07",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "CA",
            "license": "95119476",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95119476",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95017611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Jean Berman, LMFT
• Julia Elise Berman, BA
• Larry Berman
• Molly Berman, PSYD
• Zachary Tyler Berman, M.D.
• Olivia Marie Bermudez-Hopkins, M.A. CCC-SLP
• Alma Delia Bermudez
• Bernardo Bermudez
• Damian Bermudez
• Fiorella Bermudez

• Psychiatric/Mental Health Nurse Practitioner in San Diego, CA
• Providers in San Diego, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.