Healthcare Provider Details

I. General information

NPI: 1962320879
Provider Name (Legal Business Name): ZOE JULICIA BERGES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2313 I ST
EUREKA CA
95501-4244
US

IV. Provider business mailing address

3529 SPRING ST
EUREKA CA
95503-5012
US

V. Phone/Fax

Practice location:
  • Phone: 707-296-9295
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number131605
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: