Healthcare Provider Details

I. General information

NPI: 1295726321
Provider Name (Legal Business Name): SHERRI BERGAMO RN, NP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/28/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2323 16TH ST SUITE 503
BAKERSFIELD CA
93301-3420
US

IV. Provider business mailing address

PO BOX 1376
LEBEC CA
93243-1376
US

V. Phone/Fax

Practice location:
  • Phone: 661-323-0017
  • Fax: 661-323-0031
Mailing address:
  • Phone: 661-248-6611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number160566 NP 3379
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: