Healthcare Provider Details

I. General information

NPI: 1679407282
Provider Name (Legal Business Name): COLLABORATIVE TRANSFORMATIONS PSYCHOLOGY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43 QUAIL CT STE 201
WALNUT CREEK CA
94596-8703
US

IV. Provider business mailing address

43 QUAIL CT STE 201
WALNUT CREEK CA
94596-8703
US

V. Phone/Fax

Practice location:
  • Phone: 925-954-1618
  • Fax: 925-952-7022
Mailing address:
  • Phone: 925-954-1618
  • Fax: 925-952-7022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID GREEN
Title or Position: CEO AND FOUNDER
Credential: PHD
Phone: 925-954-1618