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General NPI Number Information
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NPI Number | 1790429090
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Entity Type | Individual
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Provider Name | DEANNA LEE BEREZA LCSW
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Gender | Female
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Dates
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Enumeration Date | 04/22/2022
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Last Update Date | 05/25/2025
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Provider Practice Location Address
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Address Line | 1484 POLLARD RD # 3010
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City | LOS GATOS
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State | CA
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Zip | 95032-1031
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Country | US
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Telephone | 55-261-2363
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Fax |
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Provider Business Mailing Address
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Address Line | 637 MARCELLA PL NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87123-1236
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Country | US
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Telephone | 505-261-2363
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C-11866
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW-42692
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW115258
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License Number State | CA
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