Individual
ANDREA ILENE BERGHOLTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, RN, CHPN
Contact information
Practice address
72 MOODY CT, THOUSAND OAKS, CA 91360-6067
(805) 371-9988
(805) 371-9987
Mailing address
72 MOODY CT, THOUSAND OAKS, CA 91360-6067
(805) 371-9988
(805) 371-9987
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
781694
CA
Other
Enumeration date
09/14/2020
Last updated
09/14/2020
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