Provider Demographics
NPI:1124393012
Name:BERUMEN, ANA
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:
Last Name:BERUMEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:338 LYON DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-1323
Mailing Address - Country:US
Mailing Address - Phone:702-749-9800
Mailing Address - Fax:702-749-9801
Practice Address - Street 1:6148 W SAHARA AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-3052
Practice Address - Country:US
Practice Address - Phone:702-749-9800
Practice Address - Fax:702-749-9801
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-12
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst