Provider Demographics
NPI:1760624811
Name:BERI, SHIVANI (DO)
Entity Type:Individual
Prefix:
First Name:SHIVANI
Middle Name:
Last Name:BERI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1204 BURLINGAME AVE STE 5A
Mailing Address - Street 2:
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-4139
Mailing Address - Country:US
Mailing Address - Phone:650-294-8530
Mailing Address - Fax:
Practice Address - Street 1:1204 BURLINGAME AVE STE 5A
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-4139
Practice Address - Country:US
Practice Address - Phone:650-294-8530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-02
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A127482084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry