MEDICARE: KRISTINE RENE BERRY ACSW

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	104100000X	Social Worker	ASW134057	CA

General Provider Information

NPI Number	:	1396694410
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTINE RENE BERRY ACSW

Provider Business Mailing Address
First Line	:	2426 N CENTRAL CT
Second Line	:
City	:	VISALIA
State	:	CA
Zip	:	93291-2482
Country	:	US
Telephone Number	:	559-900-6598
Fax Number	:

Provider Business Practice Location Address
First Line	:	2426 N CENTRAL CT
Second Line	:
City	:	VISALIA
State	:	CA
Zip	:	93291-2482
Country	:	US
Telephone Number	:	559-900-6598
Fax Number	:

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

Provider Enumeration Date	:	01/22/2026
Last Update Date	:	04/10/2026

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