Organization
BAY AREA CHILDREN FIRST- BERKELEY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN REGAN MFT (EXECUTIVE DIRECTOR)
(415) 563-4342
Entity
Organization
Contact information
Practice address
1400 SHATTUCK AVE, SUITE 7, BERKELEY, CA 94709-1411
(510) 883-9312
Mailing address
1400 SHATTUCK AVE, SUITE 7, BERKELEY, CA 94709
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
07 00037246
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01BZ
MEDI-CAL PROVIDER NUMBER
CA
Enumeration date
07/23/2007
Last updated
07/23/2007
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