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NPI Code Detail

MEDICARE: CLEARWATER PSYCHOLOGICAL SERVICES

MEDICARE: CLEARWATER PSYCHOLOGICAL SERVICES
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
1103T00000XPsychologistPSY 16276CA

General Provider Information

NPI Number : 1083810527
Entity Type Code : Organization
Provider Name (Legal Business Name) : CLEARWATER PSYCHOLOGICAL SERVICES
Provider Business Mailing Address
First Line : 345 38TH ST
Second Line :
City : OAKLAND
State : CA
Zip : 94609-2703
Country : US
Telephone Number : 510-596-8137
Fax Number :
Provider Business Practice Location Address
First Line : 345 38TH ST
Second Line :
City : OAKLAND
State : CA
Zip : 94609-2703
Country : US
Telephone Number : 510-596-8137
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : DR. SHARON WITKIN
Credential : PH.D.
Telephone Number : 510-596-8137
Provider Enumeration Date : 06/22/2007
Last Update Date : 08/22/2020

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Directions to “CLEARWATER PSYCHOLOGICAL SERVICES ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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