Provider Demographics
NPI:1609850593
Name:SEMINARIO, BERENEICE SHERRI (PHD)
Entity Type:Individual
Prefix:
First Name:BERENEICE
Middle Name:SHERRI
Last Name:SEMINARIO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:BERENEICE
Other - Middle Name:SHERRI
Other - Last Name:GEROLTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1300
Mailing Address - Street 2:
Mailing Address - City:DELANO
Mailing Address - State:CA
Mailing Address - Zip Code:93216-1300
Mailing Address - Country:US
Mailing Address - Phone:818-384-8515
Mailing Address - Fax:
Practice Address - Street 1:1425 MAIN STREET
Practice Address - Street 2:
Practice Address - City:DELANO
Practice Address - State:CA
Practice Address - Zip Code:93215-1726
Practice Address - Country:US
Practice Address - Phone:310-652-8552
Practice Address - Fax:661-721-1342
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-04
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 15078103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP15078Medicare UPIN
CACP15078Medicare PIN