Provider Demographics
NPI:1316171341
Name:BERG, CATHERINE ANNE (NP, FNP-BC, ACNP-BC)
Entity type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:ANNE
Last Name:BERG
Suffix:
Gender:F
Credentials:NP, FNP-BC, ACNP-BC
Other - Prefix:MISS
Other - First Name:CATHERINE
Other - Middle Name:ANNE
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:171 SAND CREEK RD STE A
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-7345
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:171 SAND CREEK RD STE A
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:CA
Practice Address - Zip Code:94513-7345
Practice Address - Country:US
Practice Address - Phone:800-495-8885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-05
Last Update Date:2017-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP-18289363LA2100X
CA18289363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care