Provider Demographics
NPI:1568653715
Name:BERN, ARTHUR CARL JR (LVN)
Entity Type:Individual
Prefix:MR
First Name:ARTHUR
Middle Name:CARL
Last Name:BERN
Suffix:JR
Gender:M
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:951 COYOTE MT DR
Mailing Address - Street 2:
Mailing Address - City:COLFAX
Mailing Address - State:CA
Mailing Address - Zip Code:95713-9606
Mailing Address - Country:US
Mailing Address - Phone:530-637-4618
Mailing Address - Fax:
Practice Address - Street 1:951 COYOTE MT DR
Practice Address - Street 2:
Practice Address - City:COLFAX
Practice Address - State:CA
Practice Address - Zip Code:95713-9606
Practice Address - Country:US
Practice Address - Phone:530-637-4618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN110073164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse