Provider Demographics
NPI:1245079995
Name:BERNAL, IRIS JULIENNE
Entity type:Individual
Prefix:
First Name:IRIS
Middle Name:JULIENNE
Last Name:BERNAL
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 1:1796 N ALBRIGHT AVE
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91784-1823
Mailing Address - Country:US
Mailing Address - Phone:626-833-0880
Mailing Address - Fax:
Practice Address - Street 1:818 N MOUNTAIN AVE STE 207
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-4165
Practice Address - Country:US
Practice Address - Phone:909-278-7042
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant