Healthcare Provider Details

I. General information

NPI: 1558568865
Provider Name (Legal Business Name): UMEE A DAVAE D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2007
Last Update Date: 05/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 MILVIA ST STE 300
BERKELEY CA
94704
US

IV. Provider business mailing address

3060 EL CERRITO PLZ # 202
EL CERRITO CA
94530-4011
US

V. Phone/Fax

Practice location:
  • Phone: 510-843-2220
  • Fax: 510-843-2227
Mailing address:
  • Phone: 847-250-7573
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number125049921
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number20A13509
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: