Healthcare Provider Details

I. General information

NPI: 1932263290
Provider Name (Legal Business Name): JOEL HARVEY SCHRECK L.AC.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1385 SHATTUCK AVE
BERKELEY CA
94709-1481
US

IV. Provider business mailing address

689 CRESTON RD
BERKELEY CA
94708-1239
US

V. Phone/Fax

Practice location:
  • Phone: 510-848-4372
  • Fax:
Mailing address:
  • Phone: 510-848-4372
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberCB3039
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: