| |
2811 College Ave Unit A Berkeley CA 94705-2167 | |
(415) 496-6772 | |
Not Available |
Full Name | |
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Speciality | Psychologist |
Location | 2811 College Ave Unit A, Berkeley, California |
Authorized Official Name and Position | Shawn Goozh (PSYCHOLOGIST) |
Authorized Official Contact | 4154966772 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2811 College Ave Unit A Berkeley CA 94705-2167 Ph: (415) 496-6772 | 2811 College Ave Unit A Berkeley CA 94705-2167 Ph: (415) 496-6772 |
NPI Number | 1114314697 |
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Provider Enumeration Date | 04/22/2015 |
Last Update Date | 03/24/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1114314697 | NPI | - | NPPES |
1437517265 | Other | CA | NPI |
1841554169 | Other | CA | NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103T00000X | Psychologist | PSY24755 (California) | Primary |
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