1942797956 NPI number — DR. ANNE ELIZABETH BERENS MD

Table of content: DR. ANNE ELIZABETH BERENS MD (NPI 1942797956)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942797956 NPI number — DR. ANNE ELIZABETH BERENS MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BERENS
Provider First Name:
ANNE
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KALT
Provider Other First Name:
ANNE
Provider Other Middle Name:
ELIZABETH
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1942797956
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/14/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
178 HILLSIDE AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MENLO PARK
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94025-6538
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
857-400-6114
Provider Business Mailing Address Fax Number:
650-530-1538

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
120B SANTA MARGARITA AVE STE 3
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MENLO PARK
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94025-2725
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
408-438-5179
Provider Business Practice Location Address Fax Number:
650-530-1538
Provider Enumeration Date:
04/16/2018

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2080P0006X , with the licence number:  A164834 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: A164834 . This is a "CA MEDICAL LICENSE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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