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General NPI Number Information
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NPI Number | 1417148636
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Entity Type | Individual
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Provider Name | MEAGHAN L CONNORS M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/05/2007
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Last Update Date | 06/29/2019
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Provider Practice Location Address
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Address Line | 2001 DWIGHT WAY STE 4190
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City | BERKELEY
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State | CA
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Zip | 94704-2608
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Country | US
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Telephone | 510-204-4635
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Fax | 510-204-3060
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Provider Business Mailing Address
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Address Line | 1330 LINCOLN AVE STE 303
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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 | 510-809-0160
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Fax | 415-454-8591
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | C56008
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License Number State | CA
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