Provider Demographics
NPI:1356402085
Name:BJERKE, PAMELA JUNE (MFT LPT)
Entity type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:JUNE
Last Name:BJERKE
Suffix:
Gender:F
Credentials:MFT LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2858 OLIVE HWY STE A
Mailing Address - Street 2:
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95966-6121
Mailing Address - Country:US
Mailing Address - Phone:530-538-7189
Mailing Address - Fax:
Practice Address - Street 1:2858 OLIVE HIGHWAY
Practice Address - Street 2:SUITES A B AND C
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95966
Practice Address - Country:US
Practice Address - Phone:530-538-2158
Practice Address - Fax:530-533-7188
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC39014106H00000X
CAPT26225167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Not Answered167G00000XNursing Service ProvidersLicensed Psychiatric Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
26225OtherLPT
39014OtherMFT