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General NPI Number Information
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NPI Number | 1073039533
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Entity Type | Individual
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Provider Name | AMY LORRITA BERG CPM, LM
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Gender | Female
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Dates
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Enumeration Date | 08/16/2017
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Last Update Date | 08/16/2017
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Provider Practice Location Address
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Address Line | 910 ASTER ST
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City | ESCONDIDO
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State | CA
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Zip | 92027-1648
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Country | US
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Telephone | 760-390-0009
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 461014
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City | ESCONDIDO
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State | CA
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Zip | 92046-1014
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Country | US
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Telephone | 760-390-0009
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175M00000X
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Taxonomy Name | Lay Midwife
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License Number | LM494
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License Number State | CA
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