Healthcare Provider Details

I. General information

NPI: 1275758385
Provider Name (Legal Business Name): DEMETRA PARAS PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2007
Last Update Date: 07/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

759 S VAN NESS AVE
SAN FRANCISCO CA
94110-1908
US

IV. Provider business mailing address

759 S VAN NESS AVE
SAN FRANCISCO CA
94110-1908
US

V. Phone/Fax

Practice location:
  • Phone: 415-642-4550
  • Fax: 415-695-6963
Mailing address:
  • Phone: 415-642-4550
  • Fax: 415-695-6963

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY17784
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: