Provider Demographics
NPI:1902958093
Name:SCHENQUERMAN, BERTA NOEMI (PHD)
Entity Type:Individual
Prefix:DR
First Name:BERTA
Middle Name:NOEMI
Last Name:SCHENQUERMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:BERTA
Other - Middle Name:NOEMI
Other - Last Name:SCHENQUERMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:4141 GEARY BLVD # G310
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-3109
Mailing Address - Country:US
Mailing Address - Phone:415-833-3169
Mailing Address - Fax:415-833-1450
Practice Address - Street 1:4141 GEARY BLVD # G310
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-3109
Practice Address - Country:US
Practice Address - Phone:415-833-3169
Practice Address - Fax:415-833-1450
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY9915103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist