Healthcare Provider Details
I. General information
NPI: 1376062877
Provider Name (Legal Business Name): BERKELEY ACUPUNCTURE PROJECT, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/15/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1834 UNIVERSITY AVE
BERKELEY CA
94703-1516
US
IV. Provider business mailing address
1834 UNIVERSITY AVE
BERKELEY CA
94703-1516
US
V. Phone/Fax
- Phone: 510-845-1100
- Fax:
- Phone: 510-845-1100
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | 12041 |
| License Number State | CA |
VIII. Authorized Official
Name:
JULIA
CARPENTER
Title or Position: CEO
Credential: L.AC.
Phone: 510-845-1100