# SAN MATEO PSYCHOLOGICAL SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386885077
- **Authorized official:** DR. JOHN BRADSHAW (OWNER-DIRECTOR)
- **Authorized official phone:** (650) 343-6955

## Contact information

- **Practice address:** 100 S ELLSWORTH AVE, \# 802, SAN MATEO, CA 94401-3939
- **Practice address phone:** (650) 343-6955
- **Practice address fax:** (650) 343-6981
- **Mailing address:** 100 S ELLSWORTH AVE, \# 802, SAN MATEO, CA 94401-3939
- **Mailing address phone:** (650) 343-6955
- **Mailing address fax:** (650) 343-6981

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | PSY7955 | CA | Yes |

## Other

- **Enumeration date:** 03/10/2009
- **Last updated:** 05/07/2009