Provider Demographics
NPI:1013118355
Name:BERKELEY PLACE
Entity type:Organization
Organization Name:BERKELEY PLACE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RHEA
Authorized Official - Middle Name:
Authorized Official - Last Name:GARBOOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-839-9125
Mailing Address - Street 1:6500 PINEHAVEN RD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-1247
Mailing Address - Country:US
Mailing Address - Phone:510-653-3981
Mailing Address - Fax:
Practice Address - Street 1:421 FAIRMOUNT AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-5534
Practice Address - Country:US
Practice Address - Phone:510-839-3769
Practice Address - Fax:510-839-3500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty