| |
2855 Telegraph Ave Ste 509 Berkeley CA 94705-1151 | |
(510) 835-5010 | |
(510) 835-9232 |
Full Name | |
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Speciality | Community/behavioral Health |
Location | 2855 Telegraph Ave Ste 509, Berkeley, California |
Authorized Official Name and Position | Kathryn Huber (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 5105178200 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2855 Telegraph Ave Ste 509 Berkeley CA 94705-1151 Ph: (510) 835-5010 | 2855 Telegraph Ave Ste 509 Berkeley CA 94705-1151 Ph: (510) 835-5010 |
NPI Number | 1710184072 |
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Provider Enumeration Date | 06/29/2007 |
Last Update Date | 11/12/2024 |
Certification Date | 11/12/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1710184072 | NPI | - | NPPES |
0136 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
251V00000X | Voluntary Or Charitable | (* (Not Available)) | Secondary |
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