Green Psychotherapy, PC
Psychologist, Clinical in Berkeley, CA. Organization (NPI-2).
NPI number1366001034
StatusActive
Last updated in NPPESJan 12, 2020
Details
- NPI
- 1366001034
- Entity type
- Organization (NPI-2)
- Legal business name
- Green Psychotherapy, PC
- Organization subpart
- No
- Enumeration date
- Jun 6, 2019
- Certification date
- Jan 12, 2020
- Last updated
- Jan 12, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | – | – | Yes |
| 103T00000X | Psychologist | – | – |
Practice location
2041 Bancroft Way Ste 202Berkeley, CA 94704-1443
Phone 510-612-0097
Mailing address
1918 Bonita AveBerkeley, CA 94704-1014
Other practice locations
2940 Summit St
Oakland, CA 94609-3416
Oakland, CA 94609-3416
Phone 510-612-0097
815 Hyde St
San Francisco, CA 94109-5996
San Francisco, CA 94109-5996
Phone 510-612-0097
1918 Bonita Ave
Berkeley, CA 94704-1014
Berkeley, CA 94704-1014
Phone 510-612-0097
3867 Howe St
Oakland, CA 94611-5343
Oakland, CA 94611-5343
Phone 510-612-0097
Authorized official
Douglas Vakoch
Chief Executive Officer
5106120097
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