Healthcare Provider Details

I. General information

NPI: 1295519940
Provider Name (Legal Business Name): ELI FUJITA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2023
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2130 CENTER ST STE 200
BERKELEY CA
94704-1386
US

IV. Provider business mailing address

2130 CENTER ST STE 200
BERKELEY CA
94704-1386
US

V. Phone/Fax

Practice location:
  • Phone: 510-548-8283
  • Fax: 510-548-2938
Mailing address:
  • Phone: 510-548-8283
  • Fax: 510-548-2938

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: