Healthcare Provider Details

I. General information

NPI: 1215382155
Provider Name (Legal Business Name): JONATHAN KENNETH HUEY DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2016
Last Update Date: 02/11/2026
Certification Date: 02/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 COLBY ST STE 104
BERKELEY CA
94705
US

IV. Provider business mailing address

3000 COLBY ST STE 104
BERKELEY CA
94705-2090
US

V. Phone/Fax

Practice location:
  • Phone: 510-849-3800
  • Fax:
Mailing address:
  • Phone: 510-849-3800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE5559
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: