Provider Demographics
NPI:1023262730
Name:YERIMA, BAKARI JULIUS
Entity type:Individual
Prefix:
First Name:BAKARI
Middle Name:JULIUS
Last Name:YERIMA
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 1:13152 KARA LN
Mailing Address - Street 2:13152 KARA LANE
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-3451
Mailing Address - Country:US
Mailing Address - Phone:240-350-7378
Mailing Address - Fax:240-696-1738
Practice Address - Street 1:13152 KARA LN
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-3451
Practice Address - Country:US
Practice Address - Phone:240-350-7378
Practice Address - Fax:240-696-1738
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-07
Last Update Date:2008-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC039844200103TM1800X, 133NN1002X, 237700000X, 320900000X, 323P00000X
DC03984420103TM1800X
0398442002355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC039844200Medicaid