Provider Demographics
NPI:1972748432
Name:BERMUDEZ, EVA GALLEGO
Entity Type:Individual
Prefix:MRS
First Name:EVA
Middle Name:GALLEGO
Last Name:BERMUDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:EVA
Other - Middle Name:GALLEGO
Other - Last Name:ZUNIGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2750 SUTTERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95820-1024
Mailing Address - Country:US
Mailing Address - Phone:916-492-7240
Mailing Address - Fax:916-736-1072
Practice Address - Street 1:2750 SUTTERVILLE RD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95820-1024
Practice Address - Country:US
Practice Address - Phone:916-492-7240
Practice Address - Fax:916-736-1072
Is Sole Proprietor?:No
Enumeration Date:2008-12-11
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health