| Big Dog Counseling, Inc. | |
|
1683 Novato Blvd Suite 1b Novato CA 94947-3200 | |
| (510) 427-7785 | |
| (510) 625-0662 |
| Full Name | Big Dog Counseling, Inc. |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 1683 Novato Blvd, Novato, California |
| Authorized Official Name and Position | Louisa Parks (PRESIDENT) |
| Authorized Official Contact | 5104277785 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Big Dog Counseling, Inc. 815 Creed Rd Oakland CA 94610-1826 Ph: (510) 427-7785 | Big Dog Counseling, Inc. 1683 Novato Blvd Suite 1b Novato CA 94947-3200 Ph: (510) 427-7785 |
| NPI Number | 1629451703 |
|---|---|
| Provider Enumeration Date | 07/07/2015 |
| Last Update Date | 08/25/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629451703 | NPI | - | NPPES |
| PSY24459 | Other | CA | CA BOARD OF PSYCHOLOGY LICENSE NUMBER |
| FX694A | Other | CA | MEDICARE PTAN |
| 816671 | Other | CA | MEDICARE UIN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | PSY24459 (California) | Primary |
| 103TC0700X | Psychologist - Clinical | PSY24459 (California) | Secondary |
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