Provider Demographics
NPI:1932176450
Name:BEJARANO, FRANK (LPC)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:
Last Name:BEJARANO
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:371 VIA CAPRI
Mailing Address - Street 2:
Mailing Address - City:RIO RICO
Mailing Address - State:AZ
Mailing Address - Zip Code:85648-1662
Mailing Address - Country:US
Mailing Address - Phone:520-313-3476
Mailing Address - Fax:520-377-8279
Practice Address - Street 1:1852 N MASTICK WAY
Practice Address - Street 2:MARIPOSA COMMUNITY HEALTH CENTER
Practice Address - City:NOGALES
Practice Address - State:AZ
Practice Address - Zip Code:85621-1063
Practice Address - Country:US
Practice Address - Phone:520-281-1550
Practice Address - Fax:520-281-1112
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC11949101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ929432Medicaid