Organization
CITY OF BERKELEY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY WALLACE (DEPUTY DIRECTOR)
(510) 981-5107
Entity
Organization
Contact information
Practice address
1890 ALCATRAZ AVE, BERKELEY, CA 94703-2715
(510) 981-5280
Mailing address
3282 ADELINE ST, BERKELEY, CA 94703-2439
(510) 981-5280
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
11/09/2016
Last updated
07/07/2020
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