Individual
BEVERLY ANN BERGMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
954 60TH ST, OAKLAND, CA 94608-2369
(510) 835-0188
(510) 835-9232
Mailing address
954 60TH ST, OAKLAND, CA 94608-2369
(510) 835-0188
(510) 835-9232
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0136
—
CA
Enumeration date
11/29/2010
Last updated
11/29/2010
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