Healthcare Provider Details

I. General information

NPI: 1144576349
Provider Name (Legal Business Name): HAGAR LIEBERMENSCH PPS# 240078476
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2012
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41717 PALM AVE
FREMONT CA
94539-4722
US

IV. Provider business mailing address

1000 BEETHOVEN CMN UNIT 303
FREMONT CA
94538-4649
US

V. Phone/Fax

Practice location:
  • Phone: 510-657-3600
  • Fax:
Mailing address:
  • Phone: 408-605-5824
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number240078476
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: