Healthcare Provider Details

I. General information

NPI: 1396753315
Provider Name (Legal Business Name): BOBETTA JEANNE BERTHELSEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37333 STATE HIGHWAY 299 E
BURNEY CA
96013
US

IV. Provider business mailing address

37333 STATE HIGHWAY 299 E
BURNEY CA
96013
US

V. Phone/Fax

Practice location:
  • Phone: 530-335-2233
  • Fax: 530-335-3933
Mailing address:
  • Phone: 530-335-2233
  • Fax: 530-335-3933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberG23953
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: