Individual
DR. JAYNE D. HAGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D
Contact information
Practice address
1213 MASONIC AVE, BERKELEY, CA 94706
(510) 778-4055
Mailing address
1213 MASONIC AVE, BERKELEY, CA 94706-2329
(510) 778-4055
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PSY22689
CA
103TC0700X
Clinical Psychologist
PSY22689
CA
Other
Enumeration date
06/23/2008
Last updated
10/29/2020
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