Provider Demographics
NPI:1275157687
Name:BADUA, BERNADETTE L (MSW)
Entity Type:Individual
Prefix:
First Name:BERNADETTE
Middle Name:L
Last Name:BADUA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1506 BROOKHOLLOW DR # 80
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-5405
Mailing Address - Country:US
Mailing Address - Phone:951-310-0601
Mailing Address - Fax:
Practice Address - Street 1:1526 BROOKHOLLOW DR STE 80
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-5421
Practice Address - Country:US
Practice Address - Phone:951-310-0601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-01
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA903981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical