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Organization
BAY AREA COLLABORATIVE PSYCHOLOGY GROUP, INC.
Active
Organization
BAY AREA COLLABORATIVE PSYCHOLOGY GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATRICK DEAN CHRISMAN PSYD (SECRETARY)
(510) 652-7011
Entity
Organization
Contact information
Practice address
4000 BROADWAY SUITE 4, OAKLAND, CA 94611
(510) 652-7011
(510) 380-5298
Mailing address
4000 BROADWAY SUITE 4, OAKLAND, CA 94611
(510) 652-7011
(510) 380-5298
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
NULL
103TC0700X
Clinical Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
NULL
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
—
Other
Enumeration date
10/22/2010
Last updated
10/22/2010
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