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General NPI Number Information
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NPI Number | 1699581645
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Entity Type | Organization
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Legal Business Name | BAY AREA PSYCHOLOGICAL SERVICES INC.
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Dates
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Enumeration Date | 12/04/2024
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Last Update Date | 12/04/2024
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Provider Practice Location Address
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Address Line | 444 ESTUDILLO AVE STE D
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City | SAN LEANDRO
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State | CA
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Zip | 94577-4923
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Country | US
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Telephone | 510-470-4900
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Fax |
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Provider Business Mailing Address
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Address Line | 1901 HARRISON ST STE 1100
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City | OAKLAND
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State | CA
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Zip | 94612-3648
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Country | US
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Telephone | 510-470-4900
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MATTHEW VERDUN
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Credential |
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Telephone | 510-470-4900
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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 |
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License Number State |
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