Provider Demographics
NPI:1942797956
Name:BERENS, ANNE ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:ELIZABETH
Last Name:BERENS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:ANNE
Other - Middle Name:ELIZABETH
Other - Last Name:KALT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3145 PORTER DR # MC5395
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304-1234
Mailing Address - Country:US
Mailing Address - Phone:650-725-8995
Mailing Address - Fax:650-724-6500
Practice Address - Street 1:1195 W FREMONT AVE
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-3832
Practice Address - Country:US
Practice Address - Phone:650-725-8995
Practice Address - Fax:650-724-6500
Is Sole Proprietor?:No
Enumeration Date:2018-04-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1648342080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA164834OtherCA MEDICAL LICENSE
CAA164834OtherCA MEDICAL LICENSE