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NPI Code Detail

MEDICARE: CITY OF BERKELEY

MEDICARE: CITY OF BERKELEY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1215963699
Entity Type Code : Organization
Provider Name (Legal Business Name) : CITY OF BERKELEY
Provider Business Mailing Address
First Line : 1521 UNIVERSITY AVE
Second Line :
City : BERKELEY
State : CA
Zip : 94703-1422
Country : US
Telephone Number : 510-981-5290
Fax Number :
Provider Business Practice Location Address
First Line : 2640 MARTIN LUTHER KING JR WAY
Second Line :
City : BERKELEY
State : CA
Zip : 94704-3238
Country : US
Telephone Number : 510-981-5290
Fax Number : 510-981-5265
Authorized Official
Title or Position : MANAGER OF MENTAL HEALTH
Name : MR. JEFF BUELL
Credential : LCSW
Telephone Number : 510-981-5290
Provider Enumeration Date : 06/25/2006
Last Update Date : 09/11/2025

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Directions to “CITY OF BERKELEY ” Practice Location

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