Provider Demographics
NPI:1831780766
Name:BERKOFF, NOAH (LCSW)
Entity type:Individual
Prefix:
First Name:NOAH
Middle Name:
Last Name:BERKOFF
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44778 COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:EL MACERO
Mailing Address - State:CA
Mailing Address - Zip Code:95618-1045
Mailing Address - Country:US
Mailing Address - Phone:541-915-6294
Mailing Address - Fax:
Practice Address - Street 1:423 F ST
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-4136
Practice Address - Country:US
Practice Address - Phone:541-915-6294
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-02
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA821791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical