Healthcare Provider Details

I. General information

NPI: 1376693861
Provider Name (Legal Business Name): CAROLYN L. ZASLAW PH.DL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5665 COLLEGE AVE STE 320C
OAKLAND CA
94618-1655
US

IV. Provider business mailing address

5665 COLLEGE AVE STE 320C
OAKLAND CA
94618-1655
US

V. Phone/Fax

Practice location:
  • Phone: 510-981-1994
  • Fax: 510-981-1994
Mailing address:
  • Phone: 510-981-1994
  • Fax: 510-981-1994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPSY12795
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: