Individual provider Active NPI

Victoria Jean Simon Berg, MA,

  • Speech-Language Pathologist
  • Paso Robles, CA
National Provider Identifier
1790295194
Registry record updated Oct 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
5316 Issued in CA
Practice address
3649 Golden Hill Rd
Paso Robles, CA 93446-6393
Phone
(805) 610-9743
NPI assigned
Oct 11, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 5316 CA Primary

Addresses

Primary practice location

3649 Golden Hill Rd
Paso Robles, CA 93446-6393

Mailing address

3649 Golden Hill Rd
Paso Robles, CA 93446-6393
Phone (805) 610-9743

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
5316CAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1507680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507680000000",
    "number": "1790295194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3649 GOLDEN HILL RD",
            "city": "PASO ROBLES",
            "state": "CA",
            "postal_code": "934466393",
            "telephone_number": "805-610-9743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3649 GOLDEN HILL RD",
            "city": "PASO ROBLES",
            "state": "CA",
            "postal_code": "934466393",
            "telephone_number": "805-610-9743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON BERG",
        "first_name": "VICTORIA",
        "middle_name": "JEAN",
        "credential": "MA,",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-11",
        "last_updated": "2017-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "5316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paso Robles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2017; 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.