Organization
ANTONIA BERCOVICI, PH.D. INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTONIA BERCOVICI (PRESIDENT)
(415) 395-9299
Entity
Organization
Contact information
Practice address
450 SUTTER ST, SUITE 2116, SAN FRANCISCO, CA 94108-4206
(415) 395-9299
(510) 647-9452
Mailing address
450 SUTTER ST, SUITE 2116, SAN FRANCISCO, CA 94108-4206
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
102L00000X
Psychoanalyst
—
—
103G00000X
Clinical Neuropsychologist
—
—
103K00000X
Behavior Analyst
—
—
103TA0700X
Adult Development & Aging Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
—
—
103TC1900X
Counseling Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TF0000X
Family Psychologist
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1184765935
TYPE 1 NPI
CA
01
—
GB074A
MEDICARE PTAN
CA
Enumeration date
06/18/2012
Last updated
06/18/2012
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