Healthcare Provider Details

I. General information

NPI: 1669303251
Provider Name (Legal Business Name): DARIA BEREZA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1530 MERIDIAN AVE # 302
SAN JOSE CA
95125-5350
US

IV. Provider business mailing address

1500 N CALIFORNIA BLVD APT 221
WALNUT CREEK CA
94596-7429
US

V. Phone/Fax

Practice location:
  • Phone: 628-587-7297
  • Fax:
Mailing address:
  • Phone: 628-587-7297
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberBACB1586554
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: