Healthcare Provider Details

I. General information

NPI: 1801691795
Provider Name (Legal Business Name): LORIE J MUELLENBACH COMPANY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3423 CATALINA AVE
ALAMEDA CA
94502-7032
US

IV. Provider business mailing address

3423 CATALINA AVE
ALAMEDA CA
94502-7032
US

V. Phone/Fax

Practice location:
  • Phone: 510-846-7820
  • Fax:
Mailing address:
  • Phone: 510-846-7820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: LORIE MUELLENBACH
Title or Position: OWNER
Credential:
Phone: 510-846-7820