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General NPI Number Information
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NPI Number | 1437180692
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Entity Type | Individual
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Provider Name | ELIZABETH A. PRESTON PHD
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Gender | Female
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Dates
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Enumeration Date | 07/06/2006
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Last Update Date | 07/10/2007
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Provider Practice Location Address
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Address Line | 1305 FRANKLIN ST STE 509
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City | OAKLAND
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State | CA
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Zip | 94612-3224
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Country | US
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Telephone | 510-482-5344
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Fax | 510-531-0915
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Provider Business Mailing Address
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Address Line | 4100 REDWOOD RD STE 10 #126
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City | OAKLAND
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State | CA
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Zip | 94619-2363
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Country | US
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Telephone | 510-482-5344
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Fax | 510-531-0915
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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 | PSY12735
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License Number State | CA
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