Provider Demographics
NPI:1326233776
Name:O'NEAL BERGER, LEANN (LMFT)
Entity Type:Individual
Prefix:
First Name:LEANN
Middle Name:
Last Name:O'NEAL BERGER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4949 WINDPLAY DR STE 270
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-9318
Mailing Address - Country:US
Mailing Address - Phone:530-676-3847
Mailing Address - Fax:530-676-3847
Practice Address - Street 1:4949 WINDPLAY DR STE 270
Practice Address - Street 2:BOX 13
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762-9318
Practice Address - Country:US
Practice Address - Phone:530-676-3847
Practice Address - Fax:530-676-3847
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-10
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC37634106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist