NPIMap

Organization Active NPI

City of Berkeley

  • Adult Mental Health Clinic/Center
  • Berkeley, CA
National Provider Identifier
1689799520
Registry record updated Jul 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
CITY OF BERKELEY
Practice address
2640 Martin Luther King Jr Way
Berkeley, CA 94704-3238
Phone
(510) 981-5290
Fax
(510) 596-9299
NPI assigned
Mar 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Yvette Katuala, MFT
Title
Mental Health Assistant Manager
Phone
(510) 981-7654

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

2640 Martin Luther King Jr Way
Berkeley, CA 94704-3238

Mailing address

3282 Adeline St
Berkeley, CA 94703-2439
Phone (510) 981-5280

Other names 1

  • Health, Housing & Community Services Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170525001891 CA Part B Supplier - Clinic/Group Practice 5294634606 Receives reassigned benefits from 32 practitioners
5 other NPIs on this enrollment
Practice locations: Berkeley, CA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 32

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 32

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625788800000",
    "number": "1689799520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3282 ADELINE ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947032439",
            "telephone_number": "510-981-5280",
            "fax_number": "510-596-9299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2640 MARTIN LUTHER KING JR WAY",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947043238",
            "telephone_number": "510-981-5290",
            "fax_number": "510-596-9299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF BERKELEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2021-07-09",
        "certification_date": "2021-07-09",
        "status": "A",
        "authorized_official_last_name": "KATUALA",
        "authorized_official_first_name": "YVETTE",
        "authorized_official_title_or_position": "MENTAL HEALTH ASSISTANT MANAGER",
        "authorized_official_telephone_number": "510-981-7654",
        "authorized_official_credential": "MFT"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Health, Housing & Community Services",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Health, Housing & Community Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.