Individual
DR. BOUKJE ELISABETH EERKENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
1050 NORTHGATE DR STE 12, SAN RAFAEL, CA 94903-2544
(415) 272-3406
(415) 300-3086
Mailing address
1050 NORTHGATE DR STE 12, SAN RAFAEL, CA 94903-2544
(415) 272-3406
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
PSY20001
CA
103TC0700X
Clinical Psychologist
Primary
PSY20001
CA
103TF0200X
Forensic Psychologist
PSY20001
CA
Other
Enumeration date
05/12/2008
Last updated
01/04/2021
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