Connie Bergman

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

675 Cliffside Dr
San Dimas, CA 91773-2957

Phone

(626) 634-1565

NPI assigned

Nov 22, 2023

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

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Progressive Learning Services LLC

  • Behavior Analyst
  • San Dimas, CA
  • NPI 1548035272
  NPD

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

{
    "created_epoch": "1700611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700611200000",
    "number": "1265207997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 CLIFFSIDE DR",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917732957",
            "telephone_number": "626-634-1565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 CLIFFSIDE DR",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917732957",
            "telephone_number": "626-634-1565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGMAN",
        "first_name": "CONNIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-22",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Belen Beltran
• Drina Beltran
• Karima Benaicha
• Alondra Benavides
• Bennett Jeong, DDS, Inc.
• Hector Betancourt
• Kayla M Bethel
• Faith Beverly, RAMFT
• Nitin Bhasin, M.D.
• Veena Kulchaiyawat Bhatarakamol, D.O.

• Behavior Technician in San Dimas, CA
• Providers in San Dimas, CA by specialty
• Behavior Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2023; 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.