Individual provider Active NPI

Veronica P Bergendahl

  • Social Worker
  • North Hollywood, CA
National Provider Identifier
1780199620
Registry record updated Mar 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
ASW86573 Issued in CA
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

Updated by the provider on Mar 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
ASW86573CAMDSocial 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.

Verify at the official NPI Registry.