Provider Demographics
NPI:1871713248
Name:BERN, MAUREEN CAROL (OTR)
Entity type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:CAROL
Last Name:BERN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:951 COYOTE MOUNTAIN DR
Mailing Address - Street 2:
Mailing Address - City:COLFAX
Mailing Address - State:CA
Mailing Address - Zip Code:95713-9606
Mailing Address - Country:US
Mailing Address - Phone:530-637-4618
Mailing Address - Fax:
Practice Address - Street 1:366 ELM AVE STE 252
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-4525
Practice Address - Country:US
Practice Address - Phone:916-367-1888
Practice Address - Fax:916-729-1611
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3780225XN1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation