Active NPI
Lynn Bertram, MD
- Psychiatry Physician
- Madera, CA
National Provider Identifier
1770549131
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- G50679
- Practice address
- 450 S Madera Ave
Madera, CA 93637-5462 - Phone
- (559) 675-4515
- NPI assigned
- Apr 25, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Medicine (Psychiatry & Neurology) Physician | 2084A0401X | G50679 | CA | |
| Addiction Psychiatry Physician | 2084P0802X | G50679 | CA | |
| Psychiatry Physician | 2084P0800X | G50679 | CA | Primary |
Addresses
Primary practice location
450 S Madera Ave
Madera, CA 93637-5462
Mailing address
1480 Moraga Rd Ste C
#399
Moraga, CA 94556-2005
Phone (925) 254-0700
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G50679 | CA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704153600000",
"number": "1770549131",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1480 MORAGA RD STE C",
"address_2": "#399",
"city": "MORAGA",
"state": "CA",
"postal_code": "945562005",
"telephone_number": "925-254-0700",
"fax_number": "925-376-2947"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450 S MADERA AVE",
"city": "MADERA",
"state": "CA",
"postal_code": "936375462",
"telephone_number": "559-675-4515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERTRAM",
"first_name": "LYNN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-25",
"last_updated": "2024-01-02",
"certification_date": "2024-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "2084A0401X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Addiction Medicine",
"state": "CA",
"license": "G50679",
"primary": false
},
{
"code": "2084P0802X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Addiction Psychiatry",
"state": "CA",
"license": "G50679",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "G50679",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Madera, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.