Healthcare Provider Details

I. General information

NPI: 1700973609
Provider Name (Legal Business Name): DENA MARIE POSITERI PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 BON AIR RD
GREENBRAE CA
94904-1702
US

IV. Provider business mailing address

970 IDYLBERRY RD
SAN RAFAEL CA
94903-1238
US

V. Phone/Fax

Practice location:
  • Phone: 415-499-6666
  • Fax:
Mailing address:
  • Phone: 415-472-7354
  • Fax: 415-472-1537

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY13022
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: