Healthcare Provider Details

I. General information

NPI: 1336982552
Provider Name (Legal Business Name): NICHOLAS CHRISTOPHER BERG MSN, RN, BSN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2024
Last Update Date: 04/05/2026
Certification Date: 04/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15141 WHITTIER BLVD STE 200
WHITTIER CA
90603-2173
US

IV. Provider business mailing address

15141 WHITTIER BLVD STE 200
WHITTIER CA
90603-2173
US

V. Phone/Fax

Practice location:
  • Phone: 562-378-6800
  • Fax: 866-680-0657
Mailing address:
  • Phone: 562-378-6800
  • Fax: 866-680-0657

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number95219682
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number95030574
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: