Provider Demographics
NPI:1073799730
Name:BERKE, MARC (PHD, LMFT)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:
Last Name:BERKE
Suffix:
Gender:M
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:913 SAN RAMON VALLEY BLVD
Mailing Address - Street 2:SUITE 280
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-4031
Mailing Address - Country:US
Mailing Address - Phone:925-838-2558
Mailing Address - Fax:925-837-0157
Practice Address - Street 1:913 SAN RAMON VALLEY BLVD
Practice Address - Street 2:SUITE 280
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526-4031
Practice Address - Country:US
Practice Address - Phone:925-838-2558
Practice Address - Fax:925-837-0157
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-11
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC15111106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist