Individual
JOHN GREGORY BERGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2640 BRESLAUER WAY, REDDING, CA 96001-4246
(530) 245-7189
Mailing address
2640 BRESLAUER WAY, REDDING, CA 96001-4246
(530) 245-7189
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
Primary
OMZWNJPKTQHLEIVS
CA
Other
Enumeration date
01/05/2021
Last updated
10/30/2024
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