KENNETH A. BERG MD
NPI 1790869865
Psychiatry & Neurology - Child & Adolescent Psychiatry in San Rafael, CA
About Kenneth A. Berg Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KENNETH A. BERG MD (NPI 1790869865) is an individual child & adolescent psychiatry provider in San Rafael, California, licensed in California (G41696) and active in the NPI registry since October 2006.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 3
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SAN RAFAEL, CA 94903
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kenneth Berg's NPI number?
The NPI number for Kenneth Berg is 1790869865. It was assigned to this individual provider in the NPPES registry on October 25, 2006.
Where is Kenneth Berg located?
Kenneth Berg practices at 99 Montecillo Rd, San Rafael, CA 94903. The listed phone number is (415) 444-2000.
What is Kenneth Berg's specialty?
The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.
When was this NPI record last updated?
The NPPES record for Kenneth Berg was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Kenneth A. Berg, MD · NPI 1790869865
Child & Adolescent Psychiatry physician in San Rafael, California. Individual provider, active in the CMS NPPES registry since October 25, 2006.
## Identity
- **NPI:** 1790869865 (Entity type: Individual)
- **Enumerated:** October 25, 2006
- **Primary specialty:** Psychiatry & Neurology - Child & Adolescent Psychiatry · taxonomy 2084P0804X
- **State license:** G41696 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 99 MONTECILLO RD, San Rafael, CA 94903-3308
- **Phone:** (415) 444-2000
## Record status
- **NPPES last updated:** July 8, 2007
- **Other identifiers:** Medicare UPIN H52707; Medicaid 00G416960 (CA); Medicare ID-Type Unspecified 00G416960
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Source: [NPI Profile](https://npiprofile.com/npi/1790869865) · Data from the CMS NPPES public registry.