Healthcare Provider Details

I. General information

NPI: 1235067505
Provider Name (Legal Business Name): GEM JANKOWSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2550 SHATTUCK AVE
BERKELEY CA
94704-2724
US

IV. Provider business mailing address

2550 SHATTUCK AVE
BERKELEY CA
94704-2724
US

V. Phone/Fax

Practice location:
  • Phone: 510-646-0822
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number20502
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: