Provider Demographics
NPI:1609907989
Name:BERUMEN, EDWARD ERNEST (PSYD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:ERNEST
Last Name:BERUMEN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 491
Mailing Address - Street 2:
Mailing Address - City:MONROVIA
Mailing Address - State:CA
Mailing Address - Zip Code:91017-0491
Mailing Address - Country:US
Mailing Address - Phone:213-260-7681
Mailing Address - Fax:213-260-7791
Practice Address - Street 1:2121 W TEMPLE ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90026-4915
Practice Address - Country:US
Practice Address - Phone:213-260-7681
Practice Address - Fax:213-260-7791
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22936103TC0700X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical