Shelly Berg

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

6253 Issued in CA

Practice address

30252 Tomas Ste 100
Rancho Santa Margarita, CA 92688-2181

Phone

(949) 282-9160

NPI assigned

Jan 26, 2020

Last updated

Jan 26, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1579996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579996800000",
    "number": "1134759459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30252 TOMAS STE 100",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "926882181",
            "telephone_number": "949-282-9160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30252 TOMAS STE 100",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "926882181",
            "telephone_number": "949-282-9160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG",
        "first_name": "SHELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-26",
        "last_updated": "2020-01-26",
        "certification_date": "2020-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CA",
            "license": "6253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robin M. Beauregard, P.T.
• Iuliia Vitalyevna Bennett, DDS
• Patricia Bennett, M.S., MFT
• Sarah Elizabeth Bennett, MA, MFTI
• Devon Rachelle Benson, LMFT
• Kristen Bergmann, SLPA
• Bianchi and Jouglard Dental Corporation (Dove Canyon Dental)
• Scott Eugene Bianchi, D.D.S.
• Elyse Biechele, DPT
• Natalia Bilan, MD

• Pediatric Occupational Therapist in Rancho Santa Margarita, CA
• Providers in Rancho Santa Margarita, CA by specialty
• Pediatric Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.