Healthcare Provider Details

I. General information

NPI: 1366725764
Provider Name (Legal Business Name): ALAMEDA NEUROPSYCH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2011
Last Update Date: 09/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1516 OAK ST SUITE 313
ALAMEDA CA
94501-2947
US

IV. Provider business mailing address

1516 OAK ST SUITE 313
ALAMEDA CA
94501-2947
US

V. Phone/Fax

Practice location:
  • Phone: 510-337-9452
  • Fax: 510-337-9452
Mailing address:
  • Phone: 510-377-9452
  • Fax: 510-377-9452

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State

VIII. Authorized Official

Name: TERESA THOMAS
Title or Position: OWNER
Credential: PHD
Phone: 510-337-9452