Provider Demographics
NPI:1982766606
Name:AFRICA, RONEL JEI (PSYD)
Entity Type:Individual
Prefix:DR
First Name:RONEL
Middle Name:JEI
Last Name:AFRICA
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:DR
Other - First Name:R.
Other - Middle Name:JEI
Other - Last Name:AFRICA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD
Mailing Address - Street 1:PO BOX 908
Mailing Address - Street 2:
Mailing Address - City:SAN CARLOS
Mailing Address - State:CA
Mailing Address - Zip Code:94070-0908
Mailing Address - Country:US
Mailing Address - Phone:650-892-3347
Mailing Address - Fax:
Practice Address - Street 1:447 SUTTER ST STE 707
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-4621
Practice Address - Country:US
Practice Address - Phone:650-892-3347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-16
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACAADE 041015101YA0400X
CAPSY 19836103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)