Healthcare Provider Details

I. General information

NPI: 1245141910
Provider Name (Legal Business Name): JONAH-CA2 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1261 61ST ST
EMERYVILLE CA
94608-2132
US

IV. Provider business mailing address

3801 3RD ST STE 305
SAN FRANCISCO CA
94124-1407
US

V. Phone/Fax

Practice location:
  • Phone: 323-283-1040
  • Fax:
Mailing address:
  • Phone: 323-282-1040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: CAROLYN RONIECE LEVIAS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 323-283-1040