MEDICARE: MR. MAXWELL JACKSON ANTOR

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1922292218
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MAXWELL JACKSON ANTOR

Provider Business Mailing Address
First Line	:	2411 SANTA CLARA AVE STE 25
Second Line	:
City	:	ALAMEDA
State	:	CA
Zip	:	94501-4543
Country	:	US
Telephone Number	:	510-575-9374
Fax Number	:

Provider Business Practice Location Address
First Line	:	2411 SANTA CLARA AVE STE 25
Second Line	:
City	:	ALAMEDA
State	:	CA
Zip	:	94501-4543
Country	:	US
Telephone Number	:	510-575-9374
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2007
Last Update Date	:	09/20/2024

Similar Medicare Providers

1528883253 — LUZ RUBY BARRIOS CMT
Practice Location Address:

2411 SANTA CLARA AVE STE 24
ALAMEDA, CA
94501-4543

Practice Phone: 925-421-3594
Practice Fax:

1265389332 — KELLY MCCALL MCCONNELL MFT, PPS
Practice Location Address:

PO BOX 3119
ALAMEDA, CA
94501-0619

Practice Phone: 510-495-7175
Practice Fax:

1689522757 — CATHERINE BARBER, LICENSED MARRIAGE AND FAMILY THERAPIST, INC.
Practice Location Address:

1926 PARK ST # 2
ALAMEDA, CA
94501-1420

Practice Phone: 669-221-4050
Practice Fax:

1154899268 — BRITTANY HUYEN CASILLAS-TA
Practice Location Address:

1025 ATLANTIC AVE STE 101
ALAMEDA, CA
94501-1188

Practice Phone: 510-268-8120
Practice Fax:

1548901440 — MR. TAIMER TAASH SORKHABI
Practice Location Address:

1025 ATLANTIC AVE STE 101
ALAMEDA, CA
94501-1188

Practice Phone: 510-268-8120
Practice Fax:

1962245597 — CHRISTOPHER STROMAN
Practice Location Address:

470 CENTRAL AVE
ALAMEDA, CA
94501-3667

Practice Phone: 626-205-8837
Practice Fax:

Directions to “ MR. MAXWELL JACKSON ANTOR ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.