Provider Demographics
NPI:1477939577
Name:BERRIAN, LOGAN (PMHNP-BC)
Entity type:Individual
Prefix:MR
First Name:LOGAN
Middle Name:
Last Name:BERRIAN
Suffix:
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 CASTRO ST STE 121
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114-1019
Mailing Address - Country:US
Mailing Address - Phone:415-565-6136
Mailing Address - Fax:
Practice Address - Street 1:45 CASTRO ST STE 121
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-1019
Practice Address - Country:US
Practice Address - Phone:415-684-5206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-31
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95034735363LP0808X
CA95052415163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health