Healthcare Provider Details

I. General information

NPI: 1932237716
Provider Name (Legal Business Name): THOMAS S BERG LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 S MAIN ST 210-B
SALINAS CA
93901-2352
US

IV. Provider business mailing address

1000 S MAIN ST 210-B
SALINAS CA
93901-2352
US

V. Phone/Fax

Practice location:
  • Phone: 831-796-1500
  • Fax: 831-757-3135
Mailing address:
  • Phone: 831-796-1500
  • Fax: 831-757-3135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number39742
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: