Healthcare Provider Details

I. General information

NPI: 1093933251
Provider Name (Legal Business Name): VANIA E. BERNATSKY N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 01/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

598 BROWNS VALLEY RD
WATSONVILLE CA
95076-0334
US

IV. Provider business mailing address

105 RANCHO RIO AVE
BEN LOMOND CA
95005-9414
US

V. Phone/Fax

Practice location:
  • Phone: 831-763-0843
  • Fax:
Mailing address:
  • Phone: 831-724-1811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP12866
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: