Individual provider Active NPI

Deborah Berardo, RPH

  • Pharmacist
  • Santa Cruz, CA
National Provider Identifier
1700288404
Registry record updated Sep 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
37725 Issued in CA
Practice address
1156 High St
Ucsc Cowell Student Health Center Pharmacy
Santa Cruz, CA 95064-1077
Phone
(831) 459-2360
Fax
(831) 459-3564
NPI assigned
Sep 24, 2014
Last updated
Sep 24, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 37725 CA Primary
Pharmacist 183500000X 1130047 MN

Addresses

Primary practice location

1156 High St
Ucsc Cowell Student Health Center Pharmacy
Santa Cruz, CA 95064-1077

Mailing address

268 Moore St
Santa Cruz, CA 95060-2514
Phone (831) 471-2106

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
1130047MNMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1411516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411516800000",
    "number": "1700288404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "268 MOORE ST",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950602514",
            "telephone_number": "831-471-2106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1156 HIGH ST",
            "address_2": "UCSC COWELL STUDENT HEALTH CENTER PHARMACY",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950641077",
            "telephone_number": "831-459-2360",
            "fax_number": "831-459-3564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERARDO",
        "first_name": "DEBORAH",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-24",
        "last_updated": "2014-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "37725",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "1130047",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.