Healthcare Provider Details

I. General information

NPI: 1467483123
Provider Name (Legal Business Name): ROBERT ANTHONY MATANO PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5665 COLLEGE AVE SUITE 320B
OAKLAND CA
94618-1625
US

IV. Provider business mailing address

5665 COLLEGE AVE SUITE 320B
OAKLAND CA
94618-1625
US

V. Phone/Fax

Practice location:
  • Phone: 510-559-9011
  • Fax: 510-526-9334
Mailing address:
  • Phone: 510-559-9011
  • Fax: 510-526-9334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License NumberPSY9841
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY9841
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: