MS. AMY BERGHOLTZ (NPI# 1124159454) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124159454 |
| Entity Type | Individual |
| Full Name | MS. AMY BERGHOLTZ |
| Credential | B.S. |
| Practice Address |
12450 Van Nuys Blvd Suite 200 Pacoima CA 91331-1391 |
| Mailing Address |
257 1/2 Isabel St. Los Angeles CA 90065 |
| Practice Telephone | 8188961161 |
| Practice Fax Number | 8188965069 |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2007-07-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 7068 | 05 | |
| CA | 7420 | 05 |
| Street Address |
12450 VAN NUYS BLVD SUITE 200 |
| City | PACOIMA |
| State | CA |
| Zip Code | 91331-1391 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578506002 | Karl Bandyan | Psychiatry & Neurology | 12450 Van Nuys Blvd, 200, Pacoima, CA 91331-1391 | 2006-06-13 |
| 1912408857 | Sarah Sluder | Case Manager/Care Coordinator | 12450 Van Nuys Blvd, Pacoima, CA 91331-1391 | 2018-02-26 |
| 1043738370 | Sam Mavis | Student in an Organized Health Care Education/Training Program | 12450 Van Nuys Blvd, Pacoima, CA 91331-1391 | 2017-09-07 |
| 1215467832 | Marcus Johnson | Case Manager/Care Coordinator | 12450 Van Nuys Blvd, Suite 200, Pacoima, CA 91331 | 2017-06-15 |
| 1982139515 | Donna Brown | Licensed Vocational Nurse | 12450 Van Nuys Blvd, 200, Pacoima, CA 91331-1391 | 2017-04-20 |
| 1114468931 | Sharron Gilmore | Case Manager/Care Coordinator | 12450 Van Nuys Blvd, 200, Pacoima, CA 91331-1391 | 2017-03-13 |
| 1629519632 | Mayra Sandoval | Case Manager/Care Coordinator | 12450 Van Nuys Blvd, Suite 200, Pacoima, CA 91331-1391 | 2017-03-10 |
| 1336689959 | Shalmar Neal | Marriage & Family Therapist | 12450 Van Nuys Blvd, Suite 200, Pacoima, CA 91331 | 2017-03-01 |
| 1275070542 | Veronica R Raniwala | Social Worker | 12450 Van Nuys Blvd, Pacoima, CA 91331 | 2017-01-25 |
| 1699212225 | Consuelo Macias | Case Manager/Care Coordinator | 12450 Van Nuys Blvd, Suite 200, Pacoima, CA 91331-1391 | 2017-01-20 |
| Find all providers in the same location | ||||
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|---|---|---|---|---|
| 1992315956 | Kimberly Marie Tallas | Dental Assistant | 9745 Laurel Canyon, Pacoima, CA 91331 | 2020-08-05 |
| 1841822574 | Hathaway-sycamores Child and Family Services | Psychologist | 11505 Herrick Ave, Pacoima, CA 91331 | 2020-02-11 |
| 1649810995 | Amaris Care Inc | Home Health | 8953 Woodman Ave Ste 201, Arleta, CA 91331 | 2020-01-14 |
| 1801453758 | Hathaway Sycamores Child and Family Services | Psychologist | 13233 Eustace St., Pacoima, CA 91331 | 2019-05-28 |
| 1083189807 | Angelina Rosina Guzman | Student in an Organized Health Care Education/Training Program | 13459 Filmore St, 1/4, Pacoima, CA 91331 | 2018-10-08 |
| 1467972364 | Msa Pharmaceutical Services Corporation | Pharmacy | 9720 Woodman Ave, Arleta, CA 91331 | 2017-06-21 |
| 1508213588 | Yari Meita Fanusie | Counselor | 11643 Glenoaks Blvd., Pacoima, CA 91331 | 2016-05-19 |
| 1972992915 | Ray Ayala | Counselor | 16643 Glenoaks Bl., Pacoima, CA 91331 | 2015-01-14 |
| 1538569249 | Ludivina Gutierrez | Occupational Therapist | 14061 Terra Bella Street, Arleta, CA 91331 | 2014-08-29 |
| 1043646557 | Umoh-chidi Daniel | Physical Therapist | 12418 Gain St., Pacoima, CA 91331 | 2013-09-17 |
| Find all providers in zip 91331 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538769831 | Jauton Wagner | Counselor | 12450 Van Nuys Blvd Ste 200, Pacoima, CA 91331-1393 | 2020-10-27 |
| 1407405186 | Ian Karlsson | Counselor | 12450 Van Nuys Blvd Ste 200, Pacoima, CA 91331-1393 | 2019-09-05 |
| 1215402375 | Vanessa Chavez | Counselor | 12450 Van Nuys Blvd Ste 200, Pacoima, CA 91331-1393 | 2018-10-04 |
| 1093214959 | Wayne Smith | Counselor | 12450 Van Nuys Blvd Ste 200, Pacoima, CA 91331-1393 | 2018-02-06 |
| 1932566346 | Vanessa Garcia | Counselor | 12450 Van Nuys Blvd Ste 200, Pacoima, CA 91331 | 2016-01-15 |
| 1699182360 | Tenisha Seniguar-morakinyo | Counselor | 12450 Van Nuys Blvd Ste 200, Pacoima, CA 91331-1393 | 2014-07-15 |
| 1356680730 | Maritza Conner | Counselor | 12450 Van Nuys Blvd, Suite 100, Pacoima, CA 91331-1391 | 2013-02-05 |
| 1407193220 | Roxana Velinda Alessio | Counselor | 12450 Van Nuys Blvd Ste 100, Pacoima, CA 91331-1392 | 2013-01-14 |
| 1477806842 | Ziesha Waters-carrico | Counselor | 12450 Van Nuys Blvd, Suite 200, Pacoima, CA 91331-1391 | 2012-10-22 |
| 1346598349 | Julia Ruelas | Counselor | 12450 Van Nuys Blvd Ste 100, Pacoima, CA 91331-1392 | 2012-08-22 |
| Find all providers in PACOIMA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.