Healthcare Provider Details

I. General information

NPI: 1235858473
Provider Name (Legal Business Name): KATHERINE ANNE CABERO OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2022
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3010 COLBY ST STE 114
BERKELEY CA
94705-2059
US

IV. Provider business mailing address

3010 COLBY ST STE 114
BERKELEY CA
94705-2059
US

V. Phone/Fax

Practice location:
  • Phone: 510-848-1413
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number35263
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOEG003896
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: