Individual
DR. BLAIR KILPATRICK-TABAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3100 MOWRY AVE, STE 410, FREMONT, CA 94538-1509
(510) 791-1036
(510) 791-1036
Mailing address
1507 ADA ST, BERKELEY, CA 94703-1001
(510) 526-4848
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY15604
CA
Other
Enumeration date
02/15/2007
Last updated
07/08/2007
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