Provider Demographics
NPI:1891830998
Name:BERGER, VELVA JANE (NP, CNP-PC)
Entity Type:Individual
Prefix:
First Name:VELVA
Middle Name:JANE
Last Name:BERGER
Suffix:
Gender:F
Credentials:NP, CNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30300 CAMINO CAPISTRANO
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN CAPISTRANO
Mailing Address - State:CA
Mailing Address - Zip Code:92675-1304
Mailing Address - Country:US
Mailing Address - Phone:949-240-2030
Mailing Address - Fax:949-429-7627
Practice Address - Street 1:30300 CAMINO CAPISTRANO
Practice Address - Street 2:
Practice Address - City:SAN JUAN CAPISTRANO
Practice Address - State:CA
Practice Address - Zip Code:92675
Practice Address - Country:US
Practice Address - Phone:949-240-2030
Practice Address - Fax:949-240-5869
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2018-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA267991363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARN2679910B12OtherCALOPTIMA
CARN267991OtherMEDICAL