DR. FRED KEITH BERGER (NPI# 1508890021) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508890021 |
| Entity Type | Individual |
| Full Name | DR. FRED KEITH BERGER |
| Credential | M.D. |
| Practice Address |
9850 Genesee Ave Suite 420 La Jolla CA 92037-1224 |
| Practice Telephone | 6192983251 |
| Practice Fax Number | 8584888839 |
| Mailing Telephone | 6192983251 |
| Mailing Fax Number | 8584888839 |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2019-01-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084A0401X |
Psychiatry & Neurology Specialization: Addiction Medicine |
G33996 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
9850 GENESEE AVE SUITE 420 |
| City | LA JOLLA |
| State | CA |
| Zip Code | 92037-1224 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598760589 | Frank Edward Mayer | Internal Medicine | 9850 Genesee Ave, Ste 930, La Jolla, CA 92037-1229 | 2005-06-16 |
| 1649717737 | La Jolla Anesthesia Associates Lp | Nurse Anesthetist, Certified Registered | 9850 Genesee Ave, Suite 980, La Jolla, CA 92037-1224 | 2017-01-26 |
| 1083151674 | Stephanie Klein | Physician Assistant | 9850 Genesee Ave, Ste 320, La Jolla, CA 92037-1208 | 2017-01-20 |
| 1346785250 | Lee Marie Atwood | Nurse Practitioner | 9850 Genesee Ave, Suite 400, La Jolla, CA 92037-1224 | 2017-01-01 |
| 1447795661 | Kirsten Goshen | Nurse Practitioner | 9850 Genesee Ave, Suite 570, La Jolla, CA 92037-1224 | 2016-12-24 |
| 1194279901 | Ellen Ashman | Nurse Practitioner | 9850 Genesee Ave, La Jolla, CA 92037-1224 | 2016-08-09 |
| 1164875175 | Miranda Mulholland | Nurse Practitioner | 9850 Genesee Ave, Suite 560, La Jolla, CA 92037-1224 | 2016-07-14 |
| 1578938023 | Schoemann Medical Corporation | Surgery | 9850 Genesee Ave, Suite 500, La Jolla, CA 92037-1224 | 2015-12-09 |
| 1679946040 | Lauren E Campagna | Physician Assistant | 9850 Genesee Ave, Suite 320, La Jolla, CA 92037-1224 | 2015-11-07 |
| 1750751269 | Charles Mears | Specialist/Technologist, Other | 9850 Genesee Ave, Suite210, La Jolla, CA 92037-1224 | 2015-09-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982221768 | Equip Health Medical, PC | Clinic/Center | 2674 Costebelle Drive, Unit A, La Jolla, CA 92037 | 2020-06-29 |
| 1134745474 | Brenda Kay Wiederhold | Psychologist | Virtual Reality Medical Center, 9834 Genesee Avenue, Suite 427, La Jolla, CA 92037 | 2020-06-23 |
| 1316581598 | Kathleen M Blechertas | Physical Therapist | 9888 Genesee, Lj19, La Jolla, CA 92037 | 2019-10-31 |
| 1316592876 | Kevin Yanyan Li | Student in an Organized Health Care Education/Training Program | 9300 Campus Point Drive, Mc7400, La Jolla, CA 92037 | 2019-08-01 |
| 1407400542 | Juan J Salmeron | Dentist | Callejin Internacional 351 L2, Los Algodones, BAJA CALIFORNIA 92037 | 2019-07-26 |
| 1609428598 | Nicole Whitney Mark | Physician Assistant | 8103 Caminito Sonoma, La Jolla, CA 92037 | 2019-07-11 |
| 1700357936 | Cecelia Rose Greene/pendzich | Mastectomy Fitter | 7760 Fay Ave, Suite M., La Jolla, CA 92037 | 2018-12-16 |
| 1740765890 | Jeenal Ankit Gordhandas | Student in an Organized Health Care Education/Training Program | East Campus Office Building, Medical Center Dr, La Jolla, CA 92037 | 2018-09-25 |
| 1306325220 | Lisa Beth Perlov Marks | Marriage & Family Therapist | 7734 Hershel Avenue, Suite O, La Jolla, CA 92037 | 2018-08-10 |
| 1023596731 | Uc San Diego, Pathology Dept | Pathology | East Campus Office Building, Medical Center Dr, San Diego, CA 92037 | 2018-08-03 |
| Find all providers in zip 92037 | ||||
| Taxonomy Code | 2084A0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Addiction Medicine |
| A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |
| Notes: Source: American Osteopathic Board of Neurology and Psychiatry, 2007 [1/1/2008: definition added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902117070 | Howard Barry Moss | Psychiatry & Neurology | 2139 Caminito Tiburon, La Jolla, CA 92037-7237 | 2010-06-23 |
| 1104007657 | Carla Beth Marienfeld | Psychiatry & Neurology | 8950 Villa La Jolla Dr, Suite C207, La Jolla, CA 92037-1714 | 2007-11-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992319560 | Blossoming Wellbeing Telepsychiatry | Psychiatry & Neurology | 5455 8th St Unit 81, Carpinteria, CA 93013-2433 | 2020-09-01 |
| 1962028936 | Sal Psychiatry Services | Psychiatry & Neurology | 13132 Studebaker Rd Ste 7, Norwalk, CA 90650-2562 | 2020-06-24 |
| 1932768280 | Sprenger Behavioral Medicine, Inc | Psychiatry & Neurology | 7601 Hospital Drive Suite 202, Suite 202, Sacramento, CA 95823 | 2019-06-11 |
| 1609431014 | Vaya Addiction Services | Psychiatry & Neurology | 945 University Ave Ste 101, Sacramento, CA 95825-6712 | 2019-05-01 |
| 1174081327 | Bacchus, Moghaddam, Musngi, Shwayder Medical Corp. | Psychiatry & Neurology | 6801 Park Ter # 530b, Los Angeles, CA 90045-1543 | 2019-03-06 |
| 1104330570 | Integrated Psychiatry, Inc. | Psychiatry & Neurology | 25000 Avenue Stanford Ste 173, Valencia, CA 91355-4596 | 2017-11-21 |
| 1740689694 | Mind & Body Treatment and Research Institute, PC | Psychiatry & Neurology | 5700 Division St, 200, Riverside, CA 92506-3257 | 2014-08-16 |
| 1619311206 | Margaret Barnett Yates | Psychiatry & Neurology | 13847 W Sunset Blvd, Pacific Palisades, CA 90272-4023 | 2013-04-25 |
| 1750645743 | Stefani Lafrenierre | Psychiatry & Neurology | 215 S Hickory St Ste 114, Escondido, CA 92025-4360 | 2012-06-25 |
| 1083977201 | Archangel De Leon | Psychiatry & Neurology | 7466 Sun Castle Ln, Sacramento, CA 95823-6734 | 2012-06-21 |
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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.