Jelena Berena, MD | |
401 Bicentennial Way, Santa Rosa, CA 95403-2149 | |
(707) 571-4000 | |
Not Available |
Full Name | Jelena Berena |
---|---|
Gender | Female |
Speciality | Pathology - Anatomic Pathology |
Location | 401 Bicentennial Way, Santa Rosa, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1891849550 | NPI | - | NPPES |
00A481580 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207ZP0101X | Pathology - Anatomic Pathology | A48158 (California) | Primary |
Entity Name | Permanente Medical Group Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710 |
Mailing Address | Practice Location Address |
---|---|
Jelena Berena, MD 1800 Harrison St Fl 7, Oakland, CA 94612-3466 Ph: (510) 625-6262 | Jelena Berena, MD 401 Bicentennial Way, Santa Rosa, CA 95403-2149 Ph: (707) 571-4000 |
John F. Kunkel, MD Pathology Medicare: Accepting Medicare Assignments Practice Location: 401 Bicentennial Way, Santa Rosa, CA 95403 Phone: 707-571-4000 | |
John Wolfe, MD Pathology Medicare: Accepting Medicare Assignments Practice Location: 1165 Montgomery Dr, Pathology Dept, Santa Rosa, CA 95405 Phone: 209-575-4575 Fax: 209-575-4598 | |
Dr. Joseph Stephen Wand, M.D. Pathology Medicare: Not Enrolled in Medicare Practice Location: 3715 Nielsen Rd, Santa Rosa, CA 95404 Phone: 707-527-7968 | |
Charles A Amezcua, M.D. Pathology Medicare: Accepting Medicare Assignments Practice Location: 401 Bicentennial Way, Santa Rosa, CA 95403 Phone: 707-571-4686 | |
Robert J. Risdall, MD Pathology Medicare: Not Enrolled in Medicare Practice Location: 401 Bicentennial Way, Santa Rosa, CA 95403 Phone: 707-571-4000 | |
Tiffany A. Camarillo, MD Pathology Medicare: Accepting Medicare Assignments Practice Location: 401 Bicentennial Way, Santa Rosa, CA 95403 Phone: 707-571-4000 | |
Mark Demeo, MD Pathology Medicare: Not Enrolled in Medicare Practice Location: 1165 Montgomery Dr, Pathology Dept, Santa Rosa, CA 95405 Phone: 209-575-4575 Fax: 209-575-4598 |