1043252661 NPI number — JEWISH FAMILY & COMMUNITY SERVICES EAST BAY

Table of content: MARK E WILLIAMS DC (NPI 1699847103)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043252661 NPI number — JEWISH FAMILY & COMMUNITY SERVICES EAST BAY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JEWISH FAMILY & COMMUNITY SERVICES EAST BAY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1043252661
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/16/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2484 SHATTUCK AVE
Provider Second Line Business Mailing Address:
SUITE 210
Provider Business Mailing Address City Name:
BERKELEY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94706-2076
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
925-927-2000
Provider Business Mailing Address Fax Number:
510-704-7494

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2484 SHATTUCK AVE
Provider Second Line Business Practice Location Address:
210
Provider Business Practice Location Address City Name:
BERKELEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94704-2076
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
925-927-2000
Provider Business Practice Location Address Fax Number:
510-704-7494
Provider Enumeration Date:
06/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HOLMES-KNIGHT
Authorized Official First Name:
ALLYSON
Authorized Official Middle Name:
MARIKO
Authorized Official Title or Position:
SR. DIRECTOR OF CLINICAL SERVICES
Authorized Official Telephone Number:
925-644-7552

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  ZZZ15557Z , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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