Healthcare Provider Details

I. General information

NPI: 1447656186
Provider Name (Legal Business Name): MRS. KATJA SUSANNE ZAMRIK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2014
Last Update Date: 11/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2550 SHATTUCK AVE
BERKELEY CA
94704
US

IV. Provider business mailing address

2550 SHATTUCK AVE
BERKELEY CA
94704
US

V. Phone/Fax

Practice location:
  • Phone: 510-666-8234
  • Fax: 510-666-0111
Mailing address:
  • Phone: 510-666-8234
  • Fax: 510-666-0111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number16224
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: