Provider Demographics
NPI:1922847631
Name:LEVIT, YEVGENIYA
Entity type:Individual
Prefix:
First Name:YEVGENIYA
Middle Name:
Last Name:LEVIT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:LIFELONG WILLIAM JENKINS HEALTH CENTER 150 HARBOUR WAY
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94801
Mailing Address - Country:US
Mailing Address - Phone:510-981-3262
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 11247
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94712-2247
Practice Address - Country:US
Practice Address - Phone:510-981-3262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program