MEDICARE: DR. MINDY ANN WERNER-CROHN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	G53827	CA

General Provider Information

NPI Number	:	1033240155
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MINDY ANN WERNER-CROHN MD

Provider Business Mailing Address
First Line	:	2930 DOMINGO AVE # 218
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94705-2454
Country	:	US
Telephone Number	:	818-756-0050
Fax Number	:	844-756-0054

Provider Business Practice Location Address
First Line	:	2930 DOMINGO AVE # 218
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94705-2454
Country	:	US
Telephone Number	:	818-756-0050
Fax Number	:	844-756-0054

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2007
Last Update Date	:	02/03/2021

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