Healthcare Provider Details

I. General information

NPI: 1295904100
Provider Name (Legal Business Name): JOHN CHARLES BIEDA JR. LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2008
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 ADDISON ST STE 300
BERKELEY CA
94704-1165
US

IV. Provider business mailing address

2001 ADDISON ST STE 300
BERKELEY CA
94704-1165
US

V. Phone/Fax

Practice location:
  • Phone: 415-254-8207
  • Fax: 833-907-5066
Mailing address:
  • Phone: 415-254-8207
  • Fax: 833-907-5066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number42387
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: