Healthcare Provider Details

I. General information

NPI: 1457274680
Provider Name (Legal Business Name): JEFFERY THOMAS UMBERTUS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 BRIARFIELD WAY
BELMONT CA
94002-2712
US

IV. Provider business mailing address

401 BRIARFIELD WAY
BELMONT CA
94002-2712
US

V. Phone/Fax

Practice location:
  • Phone: 650-244-1444
  • Fax: 650-244-1447
Mailing address:
  • Phone: 650-244-1444
  • Fax: 650-244-1447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: