Healthcare Provider Details

I. General information

NPI: 1669477949
Provider Name (Legal Business Name): PAUL M. SAXTON PH.D., LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/14/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2220 MOUNTAIN BLVD STE 240
OAKLAND CA
94611-2905
US

IV. Provider business mailing address

2220 MOUNTAIN BLVD STE 240
OAKLAND CA
94611-2905
US

V. Phone/Fax

Practice location:
  • Phone: 510-531-0220
  • Fax:
Mailing address:
  • Phone: 510-531-0220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS3221
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: