Healthcare Provider Details

I. General information

NPI: 1942797956
Provider Name (Legal Business Name): ANNE ELIZABETH BERENS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. ANNE ELIZABETH KALT

II. Dates (important events)

Enumeration Date: 04/16/2018
Last Update Date: 05/13/2024
Certification Date: 05/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1195 W FREMONT AVE
SUNNYVALE CA
94087-3832
US

IV. Provider business mailing address

178 HILLSIDE AVE
MENLO PARK CA
94025-6538
US

V. Phone/Fax

Practice location:
  • Phone: 650-725-8995
  • Fax: 650-724-6500
Mailing address:
  • Phone: 857-400-6114
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License NumberA164834
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: