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Individual

ELISABETH RENEE BERTOLINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
2220 E GONZALES RD STE 120A-B, OXNARD, CA 93036-3707
(805) 981-5151
(805) 981-5150
Mailing address
800 S VICTORIA AVE, L4615, VCHCA - PHYSICIAN SERVICES, VENTURA, CA 93009-0003
(805) 677-5181
(805) 677-5304

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2766
CO
363A00000X
Physician Assistant
Primary
PA20093
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
90873050
CO
Enumeration date
11/10/2008
Last updated
07/10/2023
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