Provider Demographics
NPI:1669541082
Name:BERGER, PETER MILO (LCSW)
Entity type:Individual
Prefix:MR
First Name:PETER
Middle Name:MILO
Last Name:BERGER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 ALHAMBRA BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-4432
Mailing Address - Country:US
Mailing Address - Phone:916-454-5881
Mailing Address - Fax:916-454-5881
Practice Address - Street 1:801 ALHAMBRA BOULEVARD
Practice Address - Street 2:SUITE 1
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816
Practice Address - Country:US
Practice Address - Phone:916-454-5881
Practice Address - Fax:916-454-5881
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS15120101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health