Individual
JENNIFER DIANE BERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4441 E KINGS CANYON RD, FRESNO, CA 93702-3604
(209) 328-0143
Mailing address
4441 E KINGS CANYON RD, FRESNO, CA 93702-3604
(209) 328-0143
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
219668
CA
Other
Enumeration date
08/08/2011
Last updated
11/29/2023
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