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NPI 1386700136

NPI 1386700136 : ALVIN RAJA HORNSTEIN PSY.D. : SAN RAFAEL, CA

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General NPI Number Information
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    NPI Number           |    1386700136
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    Entity Type          |    Individual 
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    Provider Name        |    ALVIN RAJA HORNSTEIN PSY.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    12/28/2006
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    Last Update Date     |    06/23/2010
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Provider Practice Location Address
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    Address Line         |    1330 LINCOLN AVE SUITE 310
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    City                 |    SAN RAFAEL
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    State                |    CA
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    Zip                  |    94901-2143
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    Country              |    US
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    Telephone            |    415-779-2499
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 761 
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    City                 |    KENTFIELD
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    State                |    CA
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    Zip                  |    94914-0761
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    Country              |    US
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    Telephone            |    415-779-2499
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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        |    103TC0700X
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    Taxonomy Name        |    Clinical Psychologist
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    License Number       |    21271
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    License Number State |    CA
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