Individual
JEN BERGMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
784 NORTHRIDGE MALL, SUITE #299, SALINAS, CA 93906-2015
(831) 261-1101
Mailing address
PO BOX 1565, CHANDLER, AZ 85244-1565
(480) 241-3542
(480) 888-9601
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
64846
CA
Other
Enumeration date
01/14/2016
Last updated
01/14/2016
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