Provider Demographics
NPI:1326926684
Name:MCKINNEY, JUSTICE EUNIQUE
Entity type:Individual
Prefix:
First Name:JUSTICE
Middle Name:EUNIQUE
Last Name:MCKINNEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:547 39TH ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94805-1815
Mailing Address - Country:US
Mailing Address - Phone:510-804-5005
Mailing Address - Fax:
Practice Address - Street 1:2000 POWELL ST
Practice Address - Street 2:
Practice Address - City:EMERYVILLE
Practice Address - State:CA
Practice Address - Zip Code:94608-1804
Practice Address - Country:US
Practice Address - Phone:510-982-3773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician