Healthcare Provider Details

I. General information

NPI: 1023642147
Provider Name (Legal Business Name): ALISSA GREENBERG PSYCHOLOGY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2020
Last Update Date: 07/08/2021
Certification Date: 08/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6065 CHABOT RD
OAKLAND CA
94618-1608
US

IV. Provider business mailing address

2625 ALCATRAZ AVE # 113
BERKELEY CA
94705-2702
US

V. Phone/Fax

Practice location:
  • Phone: 925-800-3398
  • Fax:
Mailing address:
  • Phone: 925-800-3398
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. ALISSA GREENBERG
Title or Position: PRESIDENT
Credential: PHD, BCBA-D
Phone: 925-800-3398