Provider Demographics
NPI:1346470275
Name:BERG, CAROLINA SUE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MRS
First Name:CAROLINA
Middle Name:SUE
Last Name:BERG
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Gender:F
Credentials:NURSE PRACTITIONER
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Mailing Address - Street 1:1600 DIVISADERO ST.,
Mailing Address - Street 2:3RD FLOOR UROLOGY DEPARTMENT
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115
Mailing Address - Country:US
Mailing Address - Phone:415-353-7171
Mailing Address - Fax:415-353-7093
Practice Address - Street 1:1600 DIVISADERO ST.,
Practice Address - Street 2:3RD FLOOR UROLOGY DEPARTMENT
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115
Practice Address - Country:US
Practice Address - Phone:415-353-7171
Practice Address - Fax:415-353-7093
Is Sole Proprietor?:No
Enumeration Date:2009-07-27
Last Update Date:2016-04-18
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Provider Licenses
StateLicense IDTaxonomies
CA691938163W00000X
CA18146363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse