Individual
JAKE BERKOWITZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
13967 ROSCOE BLVD, PANORAMA CITY, CA 91402-4245
(818) 849-6417
Mailing address
12244 BURBANK BLVD APT 108, VALLEY VILLAGE, CA 91607-5103
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2255A2300X
ATHLETIC TRAINER
—
Enumeration date
02/16/2018
Last updated
03/17/2018
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