Individual
DAVID GAGE CUSHMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
445 BELLEVUE AVE, SUITE 202, OAKLAND, CA 94610-4923
(415) 841-2481
Mailing address
445 BELLEVUE AVE, SUITE 202, OAKLAND, CA 94610-4923
(415) 841-2481
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
CA PSY 28312
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/27/2010
Last updated
09/30/2016
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