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General NPI Number Information
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NPI Number | 1497402200
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Entity Type | Individual
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Provider Name | SUSAN RENAE BERLINER FNP, DNP
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Gender | Female
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Dates
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Enumeration Date | 03/02/2022
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 116 W. MINNESOTA AVE.
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City | MCCLOUD
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State | CA
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Zip | 96057-9605
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Country | US
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Telephone | 530-964-2389
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Fax |
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Provider Business Mailing Address
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Address Line | 2622 SAPPHIRE LN
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City | ANDERSON
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State | CA
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Zip | 96007-3679
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Country | US
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Telephone | 530-370-9028
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95032528
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License Number State | CA
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