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NPI Code Detail

MEDICARE: ANDERSON & ASSOCIATES A PSYCHOLOGICAL SERVICES CORPORATION

MEDICARE: ANDERSON & ASSOCIATES A PSYCHOLOGICAL SERVICES CORPORATION
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
1103TC0700XClinical Psychologist18142CA

General Provider Information

NPI Number : 1790265478
Entity Type Code : Organization
Provider Name (Legal Business Name) : ANDERSON & ASSOCIATES A PSYCHOLOGICAL SERVICES CORPORATION
Provider Business Mailing Address
First Line : 214 MONTAIR DR
Second Line :
City : DANVILLE
State : CA
Zip : 94526-3726
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1470 MARIA LN STE 240
Second Line :
City : WALNUT CREEK
State : CA
Zip : 94596-5399
Country : US
Telephone Number : 510-214-3434
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DIANE ANDERSON
Credential : PHD
Telephone Number : 510-214-3434
Provider Enumeration Date : 08/21/2018
Last Update Date : 04/05/2023

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