Coleman, Avery

Coleman, Avery is an individual health care provider with primary practice located at 2080 S E St , San Bernardino CA 92408-2773. He recently has only one registered license in Nursing Service Providers / Licensed Psychiatric Technician, which is considered as his primary health care specialty. Coleman, Avery can be contacted via phone (909) 388-9191.

Contact Information

Primary practice address
2080 S E St San Bernardino CA 92408-2773
Phone: (909) 388-9191
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Psychiatric Technician 167G00000X 22523 California

Profile Details

NPI number 1588016208
LBN Legal business name Coleman, Avery
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 6th, 2016
Last updated Jul 6th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588016208 NPPES
California MEDICAID 1760651178

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