Bertoli, Mara

Bertoli, Mara is an individual health care provider with primary practice located at 1255 N Dutton Ave , Santa Rosa CA 95401-4663. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Bertoli, Mara can be contacted via phone (707) 546-9400.

Contact Information

Primary practice address
1255 N Dutton Ave Santa Rosa CA 95401-4663
Phone: (707) 546-9400
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 95000942 California

Profile Details

NPI number 1700293339
LBN Legal business name Bertoli, Mara
Credentials NP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 15th, 2014
Last updated Jul 6th, 2015 - about 11 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 1700293339 NPPES
California Other CA151349 MEDICARE ID

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