Provider Demographics
NPI:1427118819
Name:BERKOWITZ LANDERS, LISA D (OD)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:D
Last Name:BERKOWITZ LANDERS
Suffix:
Gender:
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2506 ASH ST
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306-1804
Mailing Address - Country:US
Mailing Address - Phone:650-618-4220
Mailing Address - Fax:650-618-4211
Practice Address - Street 1:2506 ASH ST
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-1804
Practice Address - Country:US
Practice Address - Phone:650-618-4220
Practice Address - Fax:650-618-4211
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8670152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0153928Medicaid
CAU48590Medicare UPIN
CA0153928Medicaid