Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 95013561 | CA |
NPI | 1003454240 |
---|---|
Provider Name | Sarah Berberich |
First Address | San Jose, CA 95123-3658 |
Second Address | Campbell, CA 95008-5541 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2019 |
Last Update Date | 18/12/2019 |