MEDICARE: DR. RHONDA BERNEY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	G42950	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174617708
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RHONDA BERNEY M.D.

Provider Business Mailing Address
First Line	:	PO BOX 1449
Second Line	:
City	:	GUERNEVILLE
State	:	CA
Zip	:	95446-1449
Country	:	US
Telephone Number	:	707-869-5977
Fax Number	:	707-869-5983

Provider Business Practice Location Address
First Line	:	6800 PALM AVE
Second Line	:	SUITE C
City	:	SEBASTOPOL
State	:	CA
Zip	:	95472-4269
Country	:	US
Telephone Number	:	707-824-9000
Fax Number	:	707-824-9329

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	03/07/2023

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