| John A. Beradino, Ph.d, Inc. | |
|
15233 Ventura Blvd Suite 1204 Sherman Oaks CA 91403-2201 | |
| (310) 500-6862 | |
| Not Available |
| Full Name | John A. Beradino, Ph.d, Inc. |
|---|---|
| Speciality | Counselor |
| Location | 15233 Ventura Blvd, Sherman Oaks, California |
| Authorized Official Name and Position | John Anthony Beradino (LICENSED CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 3105006862 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| John A. Beradino, Ph.d, Inc. 15233 Ventura Blvd Suite 1204 Sherman Oaks CA 91403-2201 Ph: (310) 500-6862 | John A. Beradino, Ph.d, Inc. 15233 Ventura Blvd Suite 1204 Sherman Oaks CA 91403-2201 Ph: (310) 500-6862 |
| NPI Number | 1467830034 |
|---|---|
| Provider Enumeration Date | 05/14/2015 |
| Last Update Date | 05/14/2015 |
| Medicare PECOS PAC ID | 2163736158 |
|---|---|
| Medicare Enrollment ID | O20200221002581 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467830034 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | PSY27226 (California) | Primary |
| Provider Name | John Anthony Beradino |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1679819627 PECOS PAC ID: 3274709183 Enrollment ID: I20200221002620 |
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