Provider Demographics
NPI:1629293956
Name:BERKELEY WOMEN'S HEALTH CENTER
Entity Type:Organization
Organization Name:BERKELEY WOMEN'S HEALTH CENTER
Other - Org Name:BERKELEY HEALTH CENTER FOR WOMEN AND MEN
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GWEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROWE-LEE SYKES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-444-4300
Mailing Address - Street 1:405 14TH ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-2715
Mailing Address - Country:US
Mailing Address - Phone:510-444-4300
Mailing Address - Fax:510-444-4459
Practice Address - Street 1:10850 MACARTHUR BLVD
Practice Address - Street 2:SUITE 303
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94605-5266
Practice Address - Country:US
Practice Address - Phone:510-843-6194
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAY AREA CONSORTIUM FOR QUALITY HEALTH CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-13
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA140000170261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAEAP11969FOtherEAPC
CABT882AMedicare PIN