Individual
VIRGINIA BERGQUIST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9 STILLWATER, IRVINE, CA 92603-3426
(760) 574-2666
Mailing address
9 STILLWATER, IRVINE, CA 92603-3426
(760) 574-2666
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
160039780
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
—
Enumeration date
09/18/2019
Last updated
09/18/2019
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