Active NPI
Jennifer Ann Bergman
- Marriage & Family Therapist
- Concord, CA
National Provider Identifier
1699893602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 52673
- Practice address
- 2425 Bisso LN
Concord, CA 94520-4897 - Phone
- (925) 812-6783
- NPI assigned
- Mar 27, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 62054 | CA | |
| Marriage & Family Therapist | 106H00000X | 52673 | CA | Primary |
Addresses
Primary practice location
2425 Bisso LN
Concord, CA 94520-4897
Mailing address
2425 Bisso LN
Concord, CA 94520-4897
Phone (925) 812-6783
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 62054 | CA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
| 52673 | CA | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Seneca Family of Agencies | Past | Accepting new patients | |
| Seneca Family of Agencies | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Behavioral Health Agency
- Concord, CA
- NPI 1073643680
-
- Community/Behavioral Health Agency
- Union City, CA
- NPI 1457566085
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617235200000",
"number": "1699893602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2425 BISSO LN",
"city": "CONCORD",
"state": "CA",
"postal_code": "945204897",
"telephone_number": "925-812-6783"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2425 BISSO LN",
"city": "CONCORD",
"state": "CA",
"postal_code": "945204897",
"telephone_number": "925-812-6783"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERGMAN",
"first_name": "JENNIFER",
"middle_name": "ANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-27",
"last_updated": "2021-04-01",
"certification_date": "2021-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "62054",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "52673",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Concord, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.