Healthcare Provider Details

I. General information

NPI: 1215864814
Provider Name (Legal Business Name): NEURO PATHWAYS NEUROPSYCHOLOGY CONSULTING A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 EMBARCADERO W STE 145
OAKLAND CA
94607-4500
US

IV. Provider business mailing address

11 EMBARCADERO W STE 145
OAKLAND CA
94607-4500
US

V. Phone/Fax

Practice location:
  • Phone: 415-634-7853
  • Fax:
Mailing address:
  • Phone: 415-634-7853
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State

VIII. Authorized Official

Name: JUDITH CAVAZOS
Title or Position: PSYCHOLOGIST
Credential: PHD
Phone: 415-634-7853