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General NPI Number Information
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NPI Number | 1568976793
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Entity Type | Organization
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Legal Business Name | DR. AYELET HIRSHFELD
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Dates
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Enumeration Date | 11/27/2017
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 1101 S WINCHESTER BLVD STE G174
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City | SAN JOSE
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State | CA
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Zip | 95128-3917
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Country | US
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Telephone | 408-874-6506
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Fax | 408-663-6614
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Provider Business Mailing Address
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Address Line | 1101 S WINCHESTER BLVD STE G174
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City | SAN JOSE
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State | CA
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Zip | 95128-3917
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Country | US
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Telephone | 408-874-6506
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Fax |
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Authorized Official
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Title or Position | OWNER LICENSED CLINICAL PSYCHOLOGST
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Name | DR. AYELET HIRSHFELD
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Credential | PHD
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Telephone | 408-874-6506
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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 | PSY22767
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License Number State | CA
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