Provider Demographics
NPI:1649598137
Name:BERNARDO, JAMIE PEREZ
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:PEREZ
Last Name:BERNARDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1340 TULLY ROAD
Mailing Address - Street 2:SUITE 304
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95122-3055
Mailing Address - Country:US
Mailing Address - Phone:408-827-1390
Mailing Address - Fax:409-271-3909
Practice Address - Street 1:1340 TULLY RD
Practice Address - Street 2:SUITE 304
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95122-3055
Practice Address - Country:US
Practice Address - Phone:408-827-1390
Practice Address - Fax:409-271-3909
Is Sole Proprietor?:No
Enumeration Date:2010-05-10
Last Update Date:2010-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor