Provider Demographics
NPI:1174702401
Name:AVILA, ANTONIA L
Entity type:Individual
Prefix:
First Name:ANTONIA
Middle Name:L
Last Name:AVILA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TONI
Other - Middle Name:
Other - Last Name:AVILA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1900 6TH ST
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94710-2005
Mailing Address - Country:US
Mailing Address - Phone:510-981-5184
Mailing Address - Fax:510-981-5210
Practice Address - Street 1:1900 6TH ST
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94710-2005
Practice Address - Country:US
Practice Address - Phone:510-981-5184
Practice Address - Fax:510-981-5210
Is Sole Proprietor?:No
Enumeration Date:2007-11-02
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator