| |
840 Colusa Avenue Berkeley CA 94707-1858 | |
(510) 559-3009 | |
(510) 559-3069 |
Full Name | |
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Speciality | Community/behavioral Health |
Location | 840 Colusa Avenue, Berkeley, California |
Authorized Official Name and Position | Stephanie L Hochman (DIRECTOR OF HEALTHY COMMUNITIES) |
Authorized Official Contact | 5105593012 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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11175 San Pablo Avenue El Cerrito CA 94530-2157 Ph: (510) 559-3009 | 840 Colusa Avenue Berkeley CA 94707-1858 Ph: (510) 559-3009 |
NPI Number | 1407132863 |
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Provider Enumeration Date | 10/31/2011 |
Last Update Date | 12/10/2024 |
Certification Date | 06/17/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1407132863 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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