Individual
BERTHA TIRADO LIZARRAGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2625 ZANKER RD, 101, SAN JOSE, CA 95134-2130
(408) 325-5219
(408) 944-0468
Mailing address
2625 ZANKER RD, 101, SAN JOSE, CA 95134-2130
(408) 325-5219
(408) 944-0468
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000
000
CA
01
—
009005
FDC CREDENTIALS
CA
01
—
41528
UNICARE
CA
Enumeration date
06/17/2011
Last updated
05/29/2025
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