Provider Demographics
NPI:1205380904
Name:TSEGAI, BERHANE (RBT)
Entity Type:Individual
Prefix:
First Name:BERHANE
Middle Name:
Last Name:TSEGAI
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16782 VON KARMAN AVE
Mailing Address - Street 2:STE. 11
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92606-0600
Mailing Address - Country:US
Mailing Address - Phone:855-223-7123
Mailing Address - Fax:714-784-7516
Practice Address - Street 1:5333 MISSION CENTER ROAD
Practice Address - Street 2:SUITE 110
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-1302
Practice Address - Country:US
Practice Address - Phone:619-278-0885
Practice Address - Fax:619-692-1588
Is Sole Proprietor?:No
Enumeration Date:2016-08-10
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW416Medicare PIN