Healthcare Provider Details

I. General information

NPI: 1720547714
Provider Name (Legal Business Name): BARBARA JULIE BERNER REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2019
Last Update Date: 05/24/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 1/2 WAVECREST AVE
VENICE CA
90291-9056
US

IV. Provider business mailing address

PO BOX 53
VENICE CA
90294-0053
US

V. Phone/Fax

Practice location:
  • Phone: 310-266-5220
  • Fax:
Mailing address:
  • Phone: 310-266-5220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number267876
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: