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Organization
NEW CONNECTIONS NEUROPSYCHOLOGY, PC
Active
Organization
NEW CONNECTIONS NEUROPSYCHOLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARYANN KRUSE BENS PSYD (PRESIDENT)
(510) 944-0221
Entity
Organization
Contact information
Practice address
1057 MACARTHUR BLVD, STE 214, SAN LEANDRO, CA 94577
(510) 944-0221
Mailing address
1057 MACARTHUR BLVD, STE 214, SAN LEANDRO, CA 94577-3000
(510) 944-0221
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
PSY29300
CA
103T00000X
Psychologist
PSY29300
CA
103TC0700X
Clinical Psychologist
Primary
PSY29300
CA
103TR0400X
Rehabilitation Psychologist
PSY29300
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1891296760
NPPES
—
Enumeration date
07/20/2018
Last updated
07/22/2018
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