Provider Demographics
NPI:1861498388
Name:BERKOWITZ, JOANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:
Last Name:BERKOWITZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4948 SAN JUAN AVE
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628
Mailing Address - Country:US
Mailing Address - Phone:916-966-6287
Mailing Address - Fax:916-966-2541
Practice Address - Street 1:4948 SAN JUAN AVE
Practice Address - Street 2:
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-4606
Practice Address - Country:US
Practice Address - Phone:916-966-6287
Practice Address - Fax:916-966-2541
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG024902207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA42440Medicare UPIN
CA00G249020Medicare PIN