MEDICARE: MARK BERMAN M.A.

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	106H00000X	Marriage & Family Therapist	AMFT154699	CA

General Provider Information

NPI Number	:	1780067439
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK BERMAN M.A.

Provider Business Mailing Address
First Line	:	5417 ZELZAH AVE APT 104
Second Line	:
City	:	ENCINO
State	:	CA
Zip	:	91316-2230
Country	:	US
Telephone Number	:	818-481-5657
Fax Number	:

Provider Business Practice Location Address
First Line	:	18226 VENTURA BLVD STE 202
Second Line	:
City	:	TARZANA
State	:	CA
Zip	:	91356-4246
Country	:	US
Telephone Number	:	818-975-8097
Fax Number	:

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

Provider Enumeration Date	:	06/30/2015
Last Update Date	:	07/11/2025

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