Provider Demographics
NPI:1568871853
Name:BRETADO, BERNARDO
Entity Type:Individual
Prefix:
First Name:BERNARDO
Middle Name:
Last Name:BRETADO
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 1:2017 MARY ST
Mailing Address - Street 2:
Mailing Address - City:SANGER
Mailing Address - State:CA
Mailing Address - Zip Code:93657-2740
Mailing Address - Country:US
Mailing Address - Phone:559-304-5988
Mailing Address - Fax:
Practice Address - Street 1:5271 W PALO ALTO AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93722-3635
Practice Address - Country:US
Practice Address - Phone:559-276-2331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-12
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor