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General NPI Number Information
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NPI Number | 1790220259
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Entity Type | Individual
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Provider Name | UTE KOLLATH PH.D.
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Gender | Female
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Dates
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Enumeration Date | 12/19/2016
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Last Update Date | 12/19/2016
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Provider Practice Location Address
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Address Line | 909 S VAN NESS AVE
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City | SAN FRANCISCO
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State | CA
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Zip | 94110-2613
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Country | US
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Telephone | 415-225-5814
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Fax |
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Provider Business Mailing Address
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Address Line | 401 29TH ST SUITE 110
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City | OAKLAND
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State | CA
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Zip | 94609-3519
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Country | US
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Telephone | 510-465-2600
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Fax | 510-465-2626
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 18849
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License Number State | CA
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