| |
2300 Martin Luther King Jr Way Berkeley CA 94704-1412 | |
(510) 644-6310 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
Location | 2300 Martin Luther King Jr Way, Berkeley, California |
Authorized Official Name and Position | Brian Lukas (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 4154567724 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1480 Lincoln Ave Ste 8 San Rafael CA 94901-2085 Ph: (415) 456-7724 | 2300 Martin Luther King Jr Way Berkeley CA 94704-1412 Ph: (510) 644-6310 |
NPI Number | 1760891931 |
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Provider Enumeration Date | 08/12/2014 |
Last Update Date | 05/25/2021 |
Certification Date | 05/25/2021 |
Identifier | Type | State | Issuer |
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1760891931 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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