Healthcare Provider Details

I. General information

NPI: 1427163229
Provider Name (Legal Business Name): BAY PSYCHIATRIC ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 08/23/2023
Certification Date: 08/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 MILVIA ST STE 440
BERKELEY CA
94704-1156
US

IV. Provider business mailing address

2020 MILVIA ST STE 440
BERKELEY CA
94704-1156
US

V. Phone/Fax

Practice location:
  • Phone: 510-204-4635
  • Fax: 510-204-3060
Mailing address:
  • Phone: 510-204-4635
  • Fax: 510-204-3060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberGR0068720
License Number StateCA

VIII. Authorized Official

Name: DR. RICHARD CHARLES UNGER
Title or Position: CHIEF FINANCIAL OFFICER
Credential: MD
Phone: 510-204-4635