Healthcare Provider Details

I. General information

NPI: 1427764596
Provider Name (Legal Business Name): BGD PSYCHOLOGICAL SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2023
Last Update Date: 02/02/2023
Certification Date: 01/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

745 KATYDID CT
MARTINEZ CA
94553-2221
US

IV. Provider business mailing address

52 GOLF CLUB RD # 242
PLEASANT HILL CA
94523-1524
US

V. Phone/Fax

Practice location:
  • Phone: 510-250-2805
  • Fax:
Mailing address:
  • Phone: 510-250-2805
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. TAISHA CALDWELL-HARVEY
Title or Position: CEO
Credential: PHD
Phone: 510-250-2805