Healthcare Provider Details

I. General information

NPI: 1083384291
Provider Name (Legal Business Name): HEALTH AND WELLNESS PSYCHOLOGY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2021
Last Update Date: 11/02/2022
Certification Date: 11/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 ESTUDILLO AVE STE 201
SAN LEANDRO CA
94577-4900
US

IV. Provider business mailing address

400 ESTUDILLO AVE STE 201
SAN LEANDRO CA
94577-4900
US

V. Phone/Fax

Practice location:
  • Phone: 510-281-0727
  • Fax:
Mailing address:
  • Phone: 510-281-0727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. JOANNA ZYGMONT
Title or Position: OWNER/PSYCHOLOGIST
Credential: PSY.D.
Phone: 510-626-0082