Individual
SHELLY BERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
30252 TOMAS STE 100, RANCHO SANTA MARGARITA, CA 92688-2181
(949) 282-9160
Mailing address
30252 TOMAS STE 100, RANCHO SANTA MARGARITA, CA 92688-2181
(949) 282-9160
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
6253
CA
Other
Enumeration date
01/26/2020
Last updated
01/26/2020
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