Provider Demographics
NPI:1710457494
Name:BERKUS PSYCHIATRIC CONSULTING,APC
Entity Type:Organization
Organization Name:BERKUS PSYCHIATRIC CONSULTING,APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BERKUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD,PHD
Authorized Official - Phone:520-561-5531
Mailing Address - Street 1:9 ANZA ST
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-4415
Mailing Address - Country:US
Mailing Address - Phone:520-561-5531
Mailing Address - Fax:
Practice Address - Street 1:9 ANZA ST
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663
Practice Address - Country:US
Practice Address - Phone:949-652-7301
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-26
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty