Provider Demographics
NPI:1538479753
Name:BERGER, LYNN D (NP)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:D
Last Name:BERGER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7801 MISSION CENTER CT STE 250
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-1314
Mailing Address - Country:US
Mailing Address - Phone:619-738-5566
Mailing Address - Fax:619-566-0202
Practice Address - Street 1:230 PROSPECT PL STE 340B
Practice Address - Street 2:
Practice Address - City:CORONADO
Practice Address - State:CA
Practice Address - Zip Code:92118
Practice Address - Country:US
Practice Address - Phone:619-522-4000
Practice Address - Fax:619-435-0150
Is Sole Proprietor?:No
Enumeration Date:2010-10-21
Last Update Date:2018-07-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CANP700172163W00000X
CANP19912363LA2200X
CANP 19912363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse