Healthcare Provider Details

I. General information

NPI: 1861511016
Provider Name (Legal Business Name): ALICE SHERK FELLER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2340 WARD ST SUITE 101
BERKELEY CA
94705-1124
US

IV. Provider business mailing address

2340 WARD ST SUITE 101
BERKELEY CA
94705-1124
US

V. Phone/Fax

Practice location:
  • Phone: 510-845-6162
  • Fax:
Mailing address:
  • Phone: 510-845-6162
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG38882
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: