Healthcare Provider Details

I. General information

NPI: 1811065733
Provider Name (Legal Business Name): RICHARD HERBERT GELBARD PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7601 STONERIDGE DRIVE KAISER PERMANENTE, DEPARTMENT OF PSYCHIATRY
PLEASANTON CA
94588-2899
US

IV. Provider business mailing address

7601 STONERIDGE DRIVE DEPARTMENT OF PSYCHIATRY
PLEASANTON CA
94588-2899
US

V. Phone/Fax

Practice location:
  • Phone: 925-847-5519
  • Fax: 925-847-5593
Mailing address:
  • Phone: 925-847-5519
  • Fax: 925-847-5593

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY 12038
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: