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General NPI Number Information
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NPI Number | 1114283868
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Entity Type | Individual
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Provider Name | NEESHA PATEL PHD
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Gender | Female
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Dates
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Enumeration Date | 04/06/2012
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Last Update Date | 09/13/2013
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Provider Practice Location Address
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Address Line | 2424 DWIGHT WAY SUITE 5
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City | BERKELEY
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State | CA
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Zip | 94704-2365
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Country | US
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Telephone | 510-725-4145
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Fax |
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Provider Business Mailing Address
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Address Line | 2922 HILLEGASS AVE UNIT B
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City | BERKELEY
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State | CA
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Zip | 94705-2225
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | PSY 21861
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License Number State | CA
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