Active NPI
Julie Susanne Bergen
- Occupational Therapist
- Alameda, CA
National Provider Identifier
1710223615
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 15596
- Practice address
- 311 Centre CT
Alameda, CA 94502-6512 - Phone
- (303) 378-8735
- NPI assigned
- Dec 20, 2012
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 15596 | CA | Primary |
Addresses
Primary practice location
311 Centre CT
Alameda, CA 94502-6512
Mailing address
311 Centre CT
Alameda, CA 94502-6512
Phone (303) 378-8735
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1355961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620172800000",
"number": "1710223615",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "311 CENTRE CT",
"city": "ALAMEDA",
"state": "CA",
"postal_code": "945026512",
"telephone_number": "303-378-8735"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "311 CENTRE CT",
"city": "ALAMEDA",
"state": "CA",
"postal_code": "945026512",
"telephone_number": "303-378-8735"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERGEN",
"first_name": "JULIE",
"middle_name": "SUSANNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-12-20",
"last_updated": "2021-05-05",
"certification_date": "2021-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "15596",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alameda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 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.