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Individual
MRS. MARA BERTOLI
Active
Individual
MRS. MARA BERTOLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95000942
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CA151349
MEDICARE ID
CA
Enumeration date
07/15/2014
Last updated
07/06/2015
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