| Jewish Family & Community Services East Bay | |
|
2484 Shattuck Ave 210 Berkeley CA 94704-2076 | |
| (925) 927-2000 | |
| (510) 704-7494 |
| Full Name | Jewish Family & Community Services East Bay |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2484 Shattuck Ave, Berkeley, California |
| Authorized Official Name and Position | Allyson Mariko Holmes-knight (SR. DIRECTOR OF CLINICAL SERVICES) |
| Authorized Official Contact | 9256447552 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jewish Family & Community Services East Bay 2484 Shattuck Ave Suite 210 Berkeley CA 94706-2076 Ph: (925) 927-2000 | Jewish Family & Community Services East Bay 2484 Shattuck Ave 210 Berkeley CA 94704-2076 Ph: (925) 927-2000 |
| NPI Number | 1043252661 |
|---|---|
| Provider Enumeration Date | 06/11/2006 |
| Last Update Date | 09/16/2024 |
| Certification Date | 09/16/2024 |
| Medicare PECOS PAC ID | 0345291225 |
|---|---|
| Medicare Enrollment ID | O20071227000475 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043252661 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | ZZZ15557Z (California) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Karen M Lottman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457464224 PECOS PAC ID: 0749231629 Enrollment ID: I20050208000845 |
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