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General NPI Number Information
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NPI Number | 1518674852
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Entity Type | Organization
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Legal Business Name | SEGAL TELEPSYCHIATRY NETWORK, PLLC
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Dates
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Enumeration Date | 11/04/2022
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Last Update Date | 11/04/2022
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Provider Practice Location Address
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Address Line | 655 REDWOOD HWY FRONTAGE RD STE 240
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City | MILL VALLEY
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State | CA
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Zip | 94941-3055
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Country | US
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Telephone | 707-205-7566
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Fax |
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Provider Business Mailing Address
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Address Line | 655 REDWOOD HWY FRONTAGE RD STE 240
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City | MILL VALLEY
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State | CA
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Zip | 94941-3055
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Country | US
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Telephone | 707-205-7566
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | MRS. OLGA SEGAL
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Credential |
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Telephone | 707-205-7566
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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 |
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License Number State |
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