Berg, Mija

Berg, Mija is an individual health care provider with primary practice located at 243 Georgia Street Suite B, Vallejo CA 94590. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Berg, Mija can be contacted via phone (707) 556-8100.

Contact Information

Primary practice address
243 Georgia Street Suite B Vallejo CA 94590
Phone: (707) 556-8100
Fax: (707) 556-8107
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X NP479996 California

Profile Details

NPI number 1225123243
LBN Legal business name Berg, Mija
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 4th, 2006
Last updated Dec 13th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225123243 NPPES
California MEDICAID FHC70543G
California Other HAP70543G
California Other 55-1915
California Other ZZZ23222Z

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