Provider Demographics
NPI:1205107380
Name:BERKELEY HEALTH CENTER (FOR WOMEN AND MEN)
Entity type:Organization
Organization Name:BERKELEY HEALTH CENTER (FOR WOMEN AND MEN)
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GWENDOLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROWE-LEE SYKES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:510-843-6194
Mailing Address - Street 1:2908 ELLSWORTH ST
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-1912
Mailing Address - Country:US
Mailing Address - Phone:510-843-6194
Mailing Address - Fax:510-843-6297
Practice Address - Street 1:2908 ELLSWORTH ST
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-1912
Practice Address - Country:US
Practice Address - Phone:510-843-6194
Practice Address - Fax:510-843-6297
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAY AREA CONSORTIUM FOR QULITY HEALTH CARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-01-20
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP1584261QC1500X, 261QF0050X, 261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical