Bradley Bergan

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

281807 Issued in CA

Practice address

630 Bercut Dr
Sacramento, CA 95811-0110

Phone

(916) 441-3819

NPI assigned

Sep 18, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• El Hogar Community Services, Inc.

  • Clinic/Center
  • Sacramento, CA
  • NPI 1760560296
  NPD (past)

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

{
    "created_epoch": "1568764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568764800000",
    "number": "1851941017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6725 ADMIRAL AVE",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956283216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 BERCUT DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958110110",
            "telephone_number": "916-441-3819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGAN",
        "first_name": "BRADLEY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-18",
        "last_updated": "2019-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "281807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlan Berg
• Karrie N. Berg, D.O.
• Katherine Berg
• Michael Lawrence Berg
• Kailani Ann Bergado
• Kyle Bergantz, PA
• Karina Manayan Berge, FNP-C
• Adrienne Amelia Bergen, AMFT
• Melissa Bergen
• Greta Rose Berger, MD

• Licensed Vocational Nurse in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Licensed Vocational Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 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.