Healthcare Provider Details

I. General information

NPI: 1700246006
Provider Name (Legal Business Name): SARAH LOUGHER BERTERO R.N., B.S.N., P.H.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/29/2016
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11484 B AVE
AUBURN CA
95603-2603
US

IV. Provider business mailing address

1130 WHITNEY RANCH PKWY
ROCKLIN CA
95765-6230
US

V. Phone/Fax

Practice location:
  • Phone: 530-886-3628
  • Fax:
Mailing address:
  • Phone: 415-321-9365
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number843637
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: