Healthcare Provider Details

I. General information

NPI: 1659604759
Provider Name (Legal Business Name): ELIZABETH BASHNICK PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2009
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 KELLER AVE STE 222
OAKLAND CA
94605-4229
US

IV. Provider business mailing address

4400 KELLER AVE STE 222
OAKLAND CA
94605-4229
US

V. Phone/Fax

Practice location:
  • Phone: 510-736-6006
  • Fax:
Mailing address:
  • Phone: 510-736-6006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY28577
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: