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Organization
LIVE OAK PSYCHOLOGICAL SERVICES, PC
Active
Organization
LIVE OAK PSYCHOLOGICAL SERVICES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN RYAN PSYD (PRESIDENT)
(510) 214-2110
Entity
Organization
Contact information
Practice address
2020 MILVIA ST STE 450, BERKELEY, CA 94704-1297
(510) 214-2110
Mailing address
107 TAMALPAIS RD, BERKELEY, CA 94708-1948
(510) 872-6631
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1326523044
NPPES
CA
Enumeration date
02/05/2024
Last updated
07/28/2026
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