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NPI Code Detail

MEDICARE: MINDY WERNER-CROHN, M.D., INC,

MEDICARE: MINDY WERNER-CROHN, M.D., INC,
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist
2103TF0000XFamily Psychologist
32084P0800XPsychiatry Physician
42084P0804XChild & Adolescent Psychiatry Physician
5103T00000XPsychologist

General Provider Information

NPI Number : 1871844787
Entity Type Code : Organization
Provider Name (Legal Business Name) : MINDY WERNER-CROHN, M.D., INC,
Provider Business Mailing Address
First Line : 2930 DOMINGO AVE # 218
Second Line :
City : BERKELEY
State : CA
Zip : 94705-2454
Country : US
Telephone Number : 415-686-6847
Fax Number :
Provider Business Practice Location Address
First Line : 2199 MANZANITA DRIVE
Second Line :
City : OAKLAND
State : CA
Zip : 94611
Country : US
Telephone Number : 415-686-6847
Fax Number :
Authorized Official
Title or Position : CEO
Name : DR. JOEL CROHN
Credential : PH.D.
Telephone Number : 415-686-6847
Provider Enumeration Date : 10/02/2012
Last Update Date : 05/14/2024

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