Provider Demographics
NPI:1417662727
Name:BERMAN, MEGAN PAIGE
Entity type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:PAIGE
Last Name:BERMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1799 DAFFODIL AVE
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93004-4870
Mailing Address - Country:US
Mailing Address - Phone:805-304-8727
Mailing Address - Fax:
Practice Address - Street 1:1799 DAFFODIL AVE
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93004-4870
Practice Address - Country:US
Practice Address - Phone:805-304-8727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-20
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-25-78859103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst