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General NPI Number Information
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NPI Number | 1831151224
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Entity Type | Individual
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Provider Name | STEPHEN JOHN BERGER PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 04/03/2006
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Last Update Date | 08/26/2013
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Provider Practice Location Address
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Address Line | 3102 E. HIGHLAND AVENUE MEDICAL STAFF OFFICE
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City | PATTON
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State | CA
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Zip | 92369
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Country | US
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Telephone | 909-425-7679
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Fax | 909-425-6635
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Provider Business Mailing Address
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Address Line | 3102 E. HIGHLAND AVENUE MEDICAL STAFF OFFICE
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City | PATTON
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State | CA
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Zip | 92369
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Country | US
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Telephone | 909-425-7679
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Fax | 909-425-6635
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PS008599L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | PS008599L
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License Number State | PA
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