Healthcare Provider Details

I. General information

NPI: 1558618306
Provider Name (Legal Business Name): KRISTINA FOSTER WUNDERMAN PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2012
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5665 COLLEGE AVE STE 240B
OAKLAND CA
94618-1647
US

IV. Provider business mailing address

5665 COLLEGE AVE STE 240B
OAKLAND CA
94618-1647
US

V. Phone/Fax

Practice location:
  • Phone: 925-812-7950
  • Fax:
Mailing address:
  • Phone: 925-812-7950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY34727
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: