Individual
ANDREA DE SOUZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
2222 BANCROFT WAY, BERKELEY, CA 94720-4301
(510) 643-2020
Mailing address
2222 BANCROFT WAY, BERKELEY, CA 94720-4301
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
14515
CA
Other
Enumeration date
08/17/2012
Last updated
08/17/2012
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