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General NPI Number Information
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NPI Number | 1265975569
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Entity Type | Organization
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Legal Business Name | BAY PSYCHOTHERAPY INC
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Dates
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Enumeration Date | 11/18/2016
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2010 EDDY ST APT C
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City | SAN FRANCISCO
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State | CA
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Zip | 94115-3999
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Country | US
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Telephone | 415-509-6286
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Fax | 415-985-7444
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Provider Business Mailing Address
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Address Line | 2010 EDDY ST APT C
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City | SAN FRANCISCO
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State | CA
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Zip | 94115-3998
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Country | US
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Telephone | 415-509-6286
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Fax | 415-985-7444
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Authorized Official
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Title or Position | CEO
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Name | DR. JOSH KRIEGER
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Credential | PSY.D.
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Telephone | 415-509-6286
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY23643
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License Number State | CA
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