Provider Demographics
NPI:1235765801
Name:BIERMAN, JILL NINA
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:NINA
Last Name:BIERMAN
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 1:25322 VIA PIEDRA ROJA
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-1824
Mailing Address - Country:US
Mailing Address - Phone:949-842-1487
Mailing Address - Fax:
Practice Address - Street 1:25322 VIA PIEDRA ROJA
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-1824
Practice Address - Country:US
Practice Address - Phone:949-842-1487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-16
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist