Healthcare Provider Details

I. General information

NPI: 1518269372
Provider Name (Legal Business Name): PSYCHIATRIC ALTERNATIVES AND WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2010
Last Update Date: 07/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2010 EDDY ST SUITE C
SAN FRANCISCO CA
94115-3998
US

IV. Provider business mailing address

2010 EDDY ST SUITE C
SAN FRANCISCO CA
94115-3998
US

V. Phone/Fax

Practice location:
  • Phone: 415-237-0377
  • Fax: 415-484-1944
Mailing address:
  • Phone: 415-237-0377
  • Fax: 415-484-1944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY23643
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY15510
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number24348
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number23822
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number23653
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number23805
License Number StateCA
# 7
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA81124
License Number StateCA
# 8
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberA62986
License Number StateCA
# 9
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberG64380
License Number StateCA
# 10
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberA106140
License Number StateCA
# 11
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License NumberA53529
License Number StateCA
# 12
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number23643
License Number StateCA
# 13
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number23785
License Number StateCA
# 14
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number24678
License Number StateCA
# 15
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA84107
License Number StateCA

VIII. Authorized Official

Name: DR. JOSH KRIEGER
Title or Position: PRESIDENT
Credential: PSY.D.
Phone: 415-237-0377