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NPI Code Detail

MEDICARE: MS. HOLLY METZ PSYCH. INTERN

MEDICARE:  MS. HOLLY  METZ  PSYCH. INTERN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist

General Provider Information

NPI Number : 1003954132
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. HOLLY METZ PSYCH. INTERN
Provider Business Mailing Address
First Line : 2101 VAN NESS ST
Second Line :
City : SAN PABLO
State : CA
Zip : 94806-3622
Country : US
Telephone Number : 510-307-4169
Fax Number :
Provider Business Practice Location Address
First Line : 2101 VAN NESS ST
Second Line :
City : SAN PABLO
State : CA
Zip : 94806-3622
Country : US
Telephone Number : 510-307-4169
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2007
Last Update Date : 07/08/2007

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Directions to “ MS. HOLLY METZ PSYCH. INTERN” Practice Location

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