Provider Demographics
NPI:1801925037
Name:FLYNT, BERENICE
Entity type:Individual
Prefix:MS
First Name:BERENICE
Middle Name:
Last Name:FLYNT
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 1:313 S WATERMAN AVE
Mailing Address - Street 2:
Mailing Address - City:EL CENTRO
Mailing Address - State:CA
Mailing Address - Zip Code:92243-2215
Mailing Address - Country:US
Mailing Address - Phone:442-265-7353
Mailing Address - Fax:442-265-7351
Practice Address - Street 1:624 RUBY ST
Practice Address - Street 2:
Practice Address - City:IMPERIAL
Practice Address - State:CA
Practice Address - Zip Code:92251-2503
Practice Address - Country:US
Practice Address - Phone:760-791-1335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2025-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA373H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist