Active NPI
Veronica P Bergendahl
- Social Worker
- North Hollywood, CA
National Provider Identifier
1780199620
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- ASW86573
- Practice address
- 6736 Laurel Canyon Blvd Ste 200
North Hollywood, CA 91606-1576 - Phone
- (818) 755-8786
- NPI assigned
- Dec 13, 2017
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | ASW86573 | CA | Primary |
Addresses
Primary practice location
6736 Laurel Canyon Blvd Ste 200
North Hollywood, CA 91606-1576
Mailing address
3165 Discovery Way
Rosamond, CA 93560-6215
Phone (661) 567-2689
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 |
|---|---|---|---|
| ASW86573 | CA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1513123200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1553644800000",
"number": "1780199620",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3165 DISCOVERY WAY",
"city": "ROSAMOND",
"state": "CA",
"postal_code": "935606215",
"telephone_number": "661-567-2689"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6736 LAUREL CANYON BLVD STE 200",
"city": "NORTH HOLLYWOOD",
"state": "CA",
"postal_code": "916061576",
"telephone_number": "818-755-8786"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERGENDAHL",
"first_name": "VERONICA",
"middle_name": "P",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-12-13",
"last_updated": "2019-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "ASW86573",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in North Hollywood, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.