MEDICARE: MR. KEITH BERGER

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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1811494172
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. KEITH BERGER

Provider Business Mailing Address
First Line	:	1446 N ROOK WAY
Second Line	:
City	:	STAR
State	:	ID
Zip	:	83669-6306
Country	:	US
Telephone Number	:	661-965-8097
Fax Number	:

Provider Business Practice Location Address
First Line	:	4900 CALIFORNIA AVE STE 100A
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93309-7027
Country	:	US
Telephone Number	:	661-843-1930
Fax Number	:

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

Provider Enumeration Date	:	04/12/2018
Last Update Date	:	03/15/2026

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Directions to “ MR. KEITH BERGER ” Practice Location

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