Provider Demographics
NPI:1598784019
Name:BERG, BOBBIE (BARBARA) (MFT)
Entity Type:Individual
Prefix:DR
First Name:BOBBIE (BARBARA)
Middle Name:
Last Name:BERG
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2277 TOWNSGATE RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-2406
Mailing Address - Country:US
Mailing Address - Phone:818-991-0144
Mailing Address - Fax:
Practice Address - Street 1:2277 TOWNSGATE RD
Practice Address - Street 2:SUITE 108
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-2406
Practice Address - Country:US
Practice Address - Phone:818-991-0144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC19916106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist