Berkeley Holistic Therapy, a Marriage and Family Therapy Corporation

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Legal business name

BERKELEY HOLISTIC THERAPY, A MARRIAGE AND FAMILY THERAPY CORPORATION

Practice address

1500 Russell St
Berkeley, CA 94703-2020

Phone

(510) 545-3350

NPI assigned

Jan 21, 2021

Last updated

Jan 21, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jessica VechakulNPI 1841742350

Title

President

Phone

(510) 316-2503

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jessica Vechakul

  • Marriage & Family Therapist
  • Berkeley, CA
  • NPI 1841742350
  NPD Authorized official

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

{
    "created_epoch": "1611187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611187200000",
    "number": "1932799111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2342 SHATTUCK AVE UNIT 879",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947041517",
            "telephone_number": "510-545-3360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 RUSSELL ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947032020",
            "telephone_number": "510-545-3350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERKELEY HOLISTIC THERAPY, A MARRIAGE AND FAMILY THERAPY CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-21",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A",
        "authorized_official_last_name": "VECHAKUL",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "510-316-2503"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.