MEDICARE: CITY OF BERKELEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA0005X	Ambulatory Family Planning Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902944796
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF BERKELEY

Provider Business Mailing Address
First Line	:	1980 ALLSTON WAY # H-105
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94704-1463
Country	:	US
Telephone Number	:	510-898-9120
Fax Number	:

Provider Business Practice Location Address
First Line	:	1980 ALLSTON WAY # H-105
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94704-1463
Country	:	US
Telephone Number	:	510-898-9120
Fax Number	:

Authorized Official
Title or Position	:	CLINIC MANAGER
Name	:	LARA ERLANK
Credential	:
Telephone Number	:	510-644-6965

Provider Enumeration Date	:	02/02/2007
Last Update Date	:	08/21/2025

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1225244734 — MRS. JANE SUMMER
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1316134596 — NUALA JOAN RUDDELL RN
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1980 ALLSTON WAY RM H-105
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1407038243 — MS. ELIZABETH ADAMS STERNER
Practice Location Address:

1980 ALLSTON WAY # H-105
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Directions to “CITY OF BERKELEY ” Practice Location

Language	Start Address	Practice Location

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