Provider Demographics
NPI:1306284963
Name:BERGER, BETH CREAGER (PHD)
Entity type:Individual
Prefix:DR
First Name:BETH
Middle Name:CREAGER
Last Name:BERGER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9255 TOWNE CENTRE DR STE 810
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-3041
Mailing Address - Country:US
Mailing Address - Phone:858-442-2421
Mailing Address - Fax:858-558-8538
Practice Address - Street 1:9255 TOWNE CENTRE DR STE 810
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-3041
Practice Address - Country:US
Practice Address - Phone:858-442-2421
Practice Address - Fax:858-558-8538
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-05
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY18818103TB0200X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral