Provider Demographics
NPI:1407179682
Name:BERCUME, AARON
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:BERCUME
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2707 OLYMPIC DRIVE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93308-1524
Mailing Address - Country:US
Mailing Address - Phone:661-345-9855
Mailing Address - Fax:
Practice Address - Street 1:18200 HIGHWAY 178
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93306-9510
Practice Address - Country:US
Practice Address - Phone:661-871-9697
Practice Address - Fax:661-871-1270
Is Sole Proprietor?:No
Enumeration Date:2010-03-02
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1003942970Medicare NSC