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Mr. Berman Ivan Icabalceta JR.
Specialist in San Bruno, California
NPI 1659763282

Berman Ivan Icabalceta JR. is a Specialist based in South San Francisco, CA. Berman Ivan Icabalceta JR. practices in San Bruno, CA. The NPI Number for Berman Ivan Icabalceta JR. is 1659763282 and holds a License No. (California).

The current practice location address for Berman Ivan Icabalceta JR. is 1001 Sneath Ln Ste 307, San Bruno, CA and can be reached out via phone at 650-244-0305 and via fax at 650-244-1447.

Location: 1001 Sneath Ln Ste 307, San Bruno, CA, 94080-3606
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1659763282
Provider Name
Berman Ivan Icabalceta JR.
Credential
Provider Entity Type
Individual
Gender
Male
Address
1001 Sneath Ln Ste 307, San Bruno, CA, 94080-3606
Phone Number
650-244-0305
Fax Number
650-244-1447
Provider Enumeration Date
02/18/2015
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
38472 01 CA THE LATINO COMMISSION ADMINISTRATION
institution
Provider Business Practice Location Address Details
Address
1001 Sneath Ln Ste 307
City
San Bruno
State
California
Zip
94066
Phone Number
650-244-0305
Fax Number
650-244-1447
person
Provider Business Mailing Address Details
Address
1001 Sneath Ln Ste 307
City
San Bruno
State
California
Zip
94066
Phone Number
650-244-0305
Fax Number
650-244-1447
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
()
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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