Individual provider Active NPI

Maria Fernanda Berganza Berganza, LLP

  • Clinical Psychologist
  • Ann Arbor, MI
National Provider Identifier
1720970387
Registry record updated Jul 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6361007931 Issued in MI
Practice address
3135 S State St
Ann Arbor, MI 48108-1653
Phone
(734) 369-3180
NPI assigned
Jul 17, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 6361007931 MI Primary

Addresses

Primary practice location

3135 S State St
Ann Arbor, MI 48108-1653

Mailing address

201 Columbia Dr
South Lyon, MI 48178-1886
Phone (248) 916-2625

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

LicenseStateTypeSpecialty
6361007931MIMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1752710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752710400000",
    "number": "1720970387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 COLUMBIA DR",
            "city": "SOUTH LYON",
            "state": "MI",
            "postal_code": "481781886",
            "telephone_number": "248-916-2625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3135 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081653",
            "telephone_number": "734-369-3180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGANZA",
        "first_name": "MARIA",
        "middle_name": "FERNANDA BERGANZA",
        "credential": "LLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-07-17",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6361007931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2025; 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.