Healthcare Provider Details

I. General information

NPI: 1659481802
Provider Name (Legal Business Name): JOANNE M VILLANI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1715 SOLANO AVE STE B
BERKELEY CA
94707-2220
US

IV. Provider business mailing address

1715 SOLANO AVE STE B
BERKELEY CA
94707-2220
US

V. Phone/Fax

Practice location:
  • Phone: 510-287-5619
  • Fax: 510-524-3120
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS4378
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: