Provider Demographics
NPI:1700626108
Name:ALGAR, BERNADETTE MARIE
Entity type:Individual
Prefix:MRS
First Name:BERNADETTE
Middle Name:MARIE
Last Name:ALGAR
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 1:1004 BLUEJAY DR
Mailing Address - Street 2:
Mailing Address - City:SUISUN CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94585-2266
Mailing Address - Country:US
Mailing Address - Phone:707-315-0330
Mailing Address - Fax:
Practice Address - Street 1:3824 BUELL ST STE A2
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94619-2861
Practice Address - Country:US
Practice Address - Phone:925-727-3712
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-31
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician