Healthcare Provider Details

I. General information

NPI: 1356413181
Provider Name (Legal Business Name): JEANNE LOUISE LEVENTHAL ALEXANDER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JEANNE LOUISE LEVENTHAL MD

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 05/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2920 DOMINGO AVENUE, SUITE 204D
BERKELEY CA
94705
US

IV. Provider business mailing address

2930 DOMINGO AVENUE, #304
BERKELEY CA
94705
US

V. Phone/Fax

Practice location:
  • Phone: 510-845-9005
  • Fax: 510-981-2231
Mailing address:
  • Phone: 510-845-9005
  • Fax: 510-981-2231

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG52060
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: