Basic Information
| Provider Information | |||||||||
| NPI: | 1538382866 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BERKLEY | ||||||||
| FirstName: | JUDITH | ||||||||
| MiddleName: | C | ||||||||
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| Credential: | APRNBC-FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 230 MATTSON AVE | ||||||||
| Address2: | |||||||||
| City: | LOS GATOS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 950321108 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4082193312 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2001 THE ALAMEDA | ||||||||
| Address2: | |||||||||
| City: | SAN JOSE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 951261136 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4082617777 | ||||||||
| FaxNumber: | 4082549960 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/11/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WC1600X | 492143 | CA | Y | Nursing Service Providers | Registered Nurse | Continuing Education/Staff Development |
No ID Information.