William Lloyd Headley Jr.
Student in an Organized Health Care Education/Training Program in Berkeley, CA. Individual provider (NPI-1).
Details
- NPI
- 1962014852
- Entity type
- Individual (NPI-1)
- Name
- Mr. William Lloyd Headley Jr.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 20, 2020
- Certification date
- Aug 20, 2020
- Last updated
- Aug 20, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
1918 University Ave Ste 2bBerkeley, CA 94704-3264
Phone 510-841-1262
Mailing address
1918 University Ave Ste 2bBerkeley, CA 94704-3264
Phone 510-841-1262
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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