| |
711 Harrison St Berkeley CA 94710-1313 | |
(510) 525-8841 | |
(510) 525-5502 |
Full Name | |
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Speciality | Community/behavioral Health |
Location | 711 Harrison St, Berkeley, California |
Authorized Official Name and Position | Boona Cheema (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 5106491930 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2065 Kittredge St Ste E Berkeley CA 94704-1404 Ph: (510) 649-1930 | 711 Harrison St Berkeley CA 94710-1313 Ph: (510) 525-8841 |
NPI Number | 1497966840 |
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Provider Enumeration Date | 05/25/2007 |
Last Update Date | 01/11/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1497966840 | NPI | - | NPPES |
8136 | Other | CA | MEDI-CAL PROVIDER NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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