Provider Demographics
NPI:1851457980
Name:BERKENKOTTER, EREN (PHD)
Entity Type:Individual
Prefix:DR
First Name:EREN
Middle Name:
Last Name:BERKENKOTTER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 LAKESHORE AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94606-1187
Mailing Address - Country:US
Mailing Address - Phone:510-869-2500
Mailing Address - Fax:510-601-3912
Practice Address - Street 1:2100 LAKESHORE AVE
Practice Address - Street 2:SUITE B
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94606-1187
Practice Address - Country:US
Practice Address - Phone:510-869-2500
Practice Address - Fax:510-601-3912
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18774103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical