Active NPI
Seneca Family of Agencies
Doing business as MLK
- Community/Behavioral Health Agency
- Berkeley, CA
National Provider Identifier
1760772941
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- SENECA FAMILY OF AGENCIES
- Doing business as
- MLK
- Practice address
- 1781 Rose St Building M Room #3, 4
Berkeley, CA 94703-1048 - Phone
- (510) 317-1444
- NPI assigned
- Apr 9, 2011
- Reactivated
- Aug 20, 2024
- Last updated
- Aug 20, 2024
- Organization subpart
- Yes
- Parent organization
- SENECA FAMILY OF AGENCIES
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sandy Hobson
- Title
- Quality Assurance Director
- Phone
- (510) 725-5727
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | CA | Primary |
Addresses
Primary practice location
1781 Rose St Building M Room #3, 4
Berkeley, CA 94703-1048
Mailing address
2275 Arlington Dr
San Leandro, CA 94578-1132
Phone (510) 654-4004
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0015 | Medicaid | CA |
Other names 1
- MLK
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110713000017 | CA | Part B Supplier - Clinic/Group Practice | 7416145594 |
Receives reassigned benefits from 4 practitioners This NPI is an additional NPI on the enrollment Practice locations: Oakland, CA; Redlands, CA; Richmond, CA; Salinas, CA; San Francisco, CA; San Jose, CA; San Leandro, CA; San Rafael, CA… |
National Provider Directory
National Provider Directory- Part of
- Seneca Center
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302307200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1724112000000",
"number": "1760772941",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2275 ARLINGTON DR",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "945781132",
"telephone_number": "510-654-4004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1781 ROSE ST BUILDING M ROOM #3, 4",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947031048",
"telephone_number": "510-317-1444"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SENECA FAMILY OF AGENCIES",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "SENECA FAMILY OF AGENCIES",
"enumeration_date": "2011-04-09",
"last_updated": "2024-08-20",
"certification_date": "2023-01-06",
"deactivation_date": "2023-01-06",
"reactivation_date": "2024-08-20",
"status": "A",
"authorized_official_last_name": "HOBSON",
"authorized_official_first_name": "SANDY",
"authorized_official_title_or_position": "QUALITY ASSURANCE DIRECTOR",
"authorized_official_telephone_number": "510-725-5727"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0015",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "MLK",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Berkeley, CA
- Seneca Family of Agencies (Thousand Oaks Elementary)
- Seneca Family of Agencies (Berkeley Technology Academy)
- Seneca Family of Agencies (Sylvia Mendez Elementary School)
- Seneca Family of Agencies (Williard Middle School)
- Seneca Family of Agencies (Longfellow Middle School)
- Seneca Family of Agencies (Cragmont)
- Seneca Family of Agencies (Berkeley High)
- Merrie Sennett, LMFT, LPC
- Andrew Robert Seplow, L.AC.
- Ari Sepulveda, M.S., CCC-SLP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; 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.