Provider Demographics
NPI:1184867244
Name:BERNALDEZ, MARIA LOURDES (GNP-BC)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:LOURDES
Last Name:BERNALDEZ
Suffix:
Gender:F
Credentials:GNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10051 GAYNOR AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91343-1606
Mailing Address - Country:US
Mailing Address - Phone:310-803-7990
Mailing Address - Fax:
Practice Address - Street 1:10051 GAYNOR AVE
Practice Address - Street 2:
Practice Address - City:NORTH HILLS
Practice Address - State:CA
Practice Address - Zip Code:91343-1606
Practice Address - Country:US
Practice Address - Phone:310-803-7990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-19
Last Update Date:2009-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18446363LG0600X
CA3027364SG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No364SG0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGerontology