MEDICARE: MS. SUSAN BERKOWITZ M.S. CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SP10446	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801998349
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SUSAN BERKOWITZ M.S. CCC-SLP

Provider Business Mailing Address
First Line	:	11298 DUENDA RD
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92127-1014
Country	:	US
Telephone Number	:	619-980-0347
Fax Number	:	858-613-0347

Provider Business Practice Location Address
First Line	:	11298 DUENDA RD
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92127-1014
Country	:	US
Telephone Number	:	619-980-0347
Fax Number	:	858-613-0347

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/04/2006
Last Update Date	:	07/09/2007

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