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:
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Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760407787 NPPES
California Other P00745159 MEDICARE RAILROAD
California MEDICAID 00AX84320 MEDICARE RAILROAD
California Other 020A84320 MEDICARE RAILROAD

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