Healthcare Provider Details

I. General information

NPI: 1881301497
Provider Name (Legal Business Name): LAINIE POSECION PSYCHOLOGIST CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2022
Last Update Date: 11/02/2022
Certification Date: 08/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

529 22ND ST
OAKLAND CA
94612-1613
US

IV. Provider business mailing address

529 22ND ST
OAKLAND CA
94612-1613
US

V. Phone/Fax

Practice location:
  • Phone: 917-733-5359
  • Fax:
Mailing address:
  • Phone: 917-733-5359
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State

VIII. Authorized Official

Name: LAINIE POSECION
Title or Position: PSYCHOLOGIST
Credential: PHD
Phone: 917-733-5359