Healthcare Provider Details

I. General information

NPI: 1720891963
Provider Name (Legal Business Name): CS NEUROPSYCHOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2025
Last Update Date: 01/30/2025
Certification Date: 01/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 SOSCOL AVE # 30
NAPA CA
94559-1351
US

IV. Provider business mailing address

1700 SOSCOL AVE # 30
NAPA CA
94559-1351
US

V. Phone/Fax

Practice location:
  • Phone: 707-500-3753
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINE DONOHOE
Title or Position: LCSW
Credential: LCSW
Phone: 707-500-3753