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Individual

MS. AMY BERGHOLTZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
B.S.

Contact information

Practice address
12450 VAN NUYS BLVD, SUITE 200, PACOIMA, CA 91331-1391
(818) 896-1161
(818) 896-5069
Mailing address
257 1/2 ISABEL ST., LOS ANGELES, CA 90065

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7068
CA
05
7420
CA
Enumeration date
03/08/2007
Last updated
07/09/2007
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