Healthcare Provider Details

I. General information

NPI: 1932705662
Provider Name (Legal Business Name): EITAN SAENGER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2020
Last Update Date: 12/08/2020
Certification Date: 12/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4272 NORTON AVE
OAKLAND CA
94602-4018
US

IV. Provider business mailing address

4272 NORTON AVE
OAKLAND CA
94602-4018
US

V. Phone/Fax

Practice location:
  • Phone: 510-501-8151
  • Fax:
Mailing address:
  • Phone: 510-501-8151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number120702
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: