Kaiser Permanente
Psychologist, Clinical in San Francisco, CA. Organization (NPI-2).
NPI number1063723948
StatusActive
Last updated in NPPESJun 25, 2010
Details
- NPI
- 1063723948
- Entity type
- Organization (NPI-2)
- Legal business name
- Kaiser Permanente
- Organization subpart
- No
- Enumeration date
- Jun 25, 2010
- Last updated
- Jun 25, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | PSY 23391 | CA | Yes |
Practice location
4141 Geary Blvd Fl 3San Francisco, CA 94118-3111
Phone 415-833-4092
Mailing address
4141 Geary Blvd Fl 3San Francisco, CA 94118-3111
Phone 415-833-4092
Authorized official
Tina K Dietz
Psychologist
4158334092
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