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General NPI Number Information
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NPI Number | 1689799520
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Entity Type | Organization
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Legal Business Name | CITY OF BERKELEY
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 07/09/2021
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Provider Practice Location Address
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Address Line | 2640 MARTIN LUTHER KING JR WAY
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City | BERKELEY
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State | CA
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Zip | 94704-3238
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Country | US
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Telephone | 510-981-5290
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Fax | 510-596-9299
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Provider Business Mailing Address
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Address Line | 3282 ADELINE ST
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City | BERKELEY
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State | CA
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Zip | 94703-2439
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Country | US
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Telephone | 510-981-5280
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Fax | 510-596-9299
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Authorized Official
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Title or Position | MENTAL HEALTH ASSISTANT MANAGER
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Name | YVETTE KATUALA
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Credential | MFT
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Telephone | 510-981-7654
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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