Individual provider Active NPI

Lynn Lokelani Bergman, M.A., M.F.T.

  • Marriage & Family Therapist
  • Santa Rosa, CA
National Provider Identifier
1265677231
Registry record updated Dec 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC #45216 Issued in CA
Practice address
633 Cherry St
Santa Rosa, CA 95404-4202
Phone
(707) 570-7269
NPI assigned
Dec 4, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC #45216 CA Primary

Addresses

Primary practice location

633 Cherry St
Santa Rosa, CA 95404-4202

Mailing address

633 Cherry St
Santa Rosa, CA 95404-4202
Phone (707) 570-7269

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Jan 1, 2024 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
MFC #45216CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1228348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228348800000",
    "number": "1265677231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 CHERRY ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044202",
            "telephone_number": "707-570-7269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 CHERRY ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044202",
            "telephone_number": "707-570-7269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGMAN",
        "first_name": "LYNN",
        "middle_name": "LOKELANI",
        "name_prefix": "Ms.",
        "credential": "M.A., M.F.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-04",
        "last_updated": "2008-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC #45216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.