Provider Demographics
NPI:1215740584
Name:EBERHARDT, JOSEPHINE ANNA
Entity type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:ANNA
Last Name:EBERHARDT
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2545 HILLEGASS AVE
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94704-2913
Mailing Address - Country:US
Mailing Address - Phone:628-264-2595
Mailing Address - Fax:
Practice Address - Street 1:419 KEARNEY ST
Practice Address - Street 2:
Practice Address - City:EL CERRITO
Practice Address - State:CA
Practice Address - Zip Code:94530-3656
Practice Address - Country:US
Practice Address - Phone:628-264-5295
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-30
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist