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LORI ANDREIS BERGERON NPI 1104038777


NPI Information

NPI: 1104038777
Provider Name: LORI ANDREIS BERGERON

Doing Business As: TIBURON WELLNESS CENTER

Classification: Chiropractor - 111N00000X
Entity Type: Organization
Address:
1640 TIBURON BLVD
6
TIBURON, CA
ZIP 94920
Phone: (415) 435-7420
Get Directions

LORI ANDREIS BERGERON is a chiropractor in Tiburon, CA. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. LORI ANDREIS BERGERON NPI is 1104038777. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Tiburon Wellness Center.

The provider's business location address is:

1640 TIBURON BLVD
6
TIBURON, CA
ZIP 94920-515
Phone: (415) 435-7420
Fax: (415) 435-7424

The provider's authorized official is Gretchen K. Andreis .
The authorized official title is Doctor and has the following contact phone number (415) 435-7420.

The enumeration date for this NPI number is 5/4/2007 and was last updated on 7/25/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1111N00000XChiropractorDC21624CALIFORNIANo
2111N00000XChiropractorDC21875CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1U28517MEDICARE UPINCALIFORNIA
2DC0216240MEDICARE ID-TYPE UNSPECIFIEDCALIFORNIA
3U37871MEDICARE UPINCALIFORNIA
4DC021875MEDICARE ID-TYPE UNSPECIFIEDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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