Individual
NICOLE DANIELLE BERGHORST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
661 SIMEON CT, RIPON, CA 95366-9566
(209) 613-7605
Mailing address
11425 MAGNOLIA AVE APT 67, RIVERSIDE, CA 92505-4879
(209) 613-7605
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
7376
CA
Other
Enumeration date
09/06/2022
Last updated
09/06/2022
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