Individual
JACKIE M BERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18997 NEW YORK FLAT RD., FORBESTOWN, CA 95941-0037
(530) 675-2577
Mailing address
PO BOX 37, FORBESTOWN, CA 95941-0037
(530) 675-2577
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
12/17/2024
Last updated
01/16/2025
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