Adisa Anderson, Ph.D.
Psychologist, Counseling in Berkeley, CA. Individual provider (NPI-1).
NPI number1174938542
StatusActive
Last updated in NPPESMar 12, 2025
Details
- NPI
- 1174938542
- Entity type
- Individual (NPI-1)
- Name
- Adisa Anderson
- Credential
- Ph.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jun 24, 2014
- Certification date
- Mar 12, 2025
- Last updated
- Mar 12, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC1900X | Psychologist, Counseling | 28984 | CA | Yes |
| 101YM0800X | Counselor, Mental Health | – | – |
Practice location
2222 Bancroft Way#4300
Berkeley, CA 94720-4300
Phone 510-934-6255
Mailing address
2222 Bancroft Way Spc 4300Berkeley, CA 94720-4300
Phone 510-934-6255
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