Provider Demographics
NPI:1528076577
Name:BERLIN, ANNE MORRIS (PHD)
Entity type:Individual
Prefix:DR
First Name:ANNE
Middle Name:MORRIS
Last Name:BERLIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3197 VIA DE CABALLO
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024
Mailing Address - Country:US
Mailing Address - Phone:858-759-9215
Mailing Address - Fax:858-759-0661
Practice Address - Street 1:3252 HOLIDAY COURT
Practice Address - Street 2:SUITE 110
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037
Practice Address - Country:US
Practice Address - Phone:858-452-2500
Practice Address - Fax:858-759-0661
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY9447103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP9447Medicare ID - Type Unspecified