Individual
BARBARA JEAN BODLE-PEDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, MPH, FNP
Contact information
Practice address
2222 BANCROFT AVE., BERKELEY, CA 94720-4300
(510) 643-7117
Mailing address
77 FRANCISCAN WAY, KENSINGTON, CA 94707-1112
(510) 525-9206
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
293413, 3383
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
293413, 3383
REGISTERED NURSE, NP
CA
Enumeration date
04/26/2007
Last updated
07/08/2007
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