Provider Demographics
NPI:1508145202
Name:VON BER, INA (PHD)
Entity Type:Individual
Prefix:DR
First Name:INA
Middle Name:
Last Name:VON BER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:INA
Other - Middle Name:
Other - Last Name:SCHMILOVICI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:7825 FAY AVE
Mailing Address - Street 2:SUITE #200
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-4252
Mailing Address - Country:US
Mailing Address - Phone:858-459-1704
Mailing Address - Fax:
Practice Address - Street 1:7825 FAY AVE
Practice Address - Street 2:SUITE #200
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-4252
Practice Address - Country:US
Practice Address - Phone:858-459-1704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-11
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY20079103T00000X
MI6301010647103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist