Berrong, Stacy J
Berrong, Stacy J is an individual health care provider with primary practice located at 632 W Gibson Rd , Woodland CA 95695. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Obstetrics. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Berrong, Stacy J can be contacted via phone (530) 666-1631.Contact Information
Primary practice address
632 W Gibson Rd
Woodland CA 95695
Phone: (530) 666-1631
Fax: (530) 668-2697
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 20A8432 | California |
| Allopathic & Osteopathic Physicians / Obstetrics | 207VX0000X | 20A8432 | California |
Profile Details
| NPI number | 1760407787 |
|---|---|
| LBN Legal business name | Berrong, Stacy J |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 12th, 2006 |
| Last updated | Nov 18th, 2015 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1760407787 | NPPES |
| California | Other | P00745159 | MEDICARE RAILROAD |
| California | MEDICAID | 00AX84320 | MEDICARE RAILROAD |
| California | Other | 020A84320 | MEDICARE RAILROAD |
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