MEDICARE: DR. SHUFANG TSAI PSYCHOLOGIST, INC

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
1	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1134802226
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. SHUFANG TSAI PSYCHOLOGIST, INC

Provider Business Mailing Address
First Line	:	415 CORNELL AVE APT 204
Second Line	:
City	:	ALBANY
State	:	CA
Zip	:	94706-1277
Country	:	US
Telephone Number	:	510-684-5797
Fax Number	:	833-411-1278

Provider Business Practice Location Address
First Line	:	415 CORNELL AVE APT 204
Second Line	:
City	:	ALBANY
State	:	CA
Zip	:	94706-1277
Country	:	US
Telephone Number	:	510-684-5797
Fax Number	:	833-411-1278

Authorized Official
Title or Position	:	CLINICAL PSYCHOLOGIST
Name	:	SHUFANG TSAI
Credential	:	PSYD
Telephone Number	:	510-684-5797

Provider Enumeration Date	:	08/07/2023
Last Update Date	:	08/07/2023

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