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Individual

ADISA ANDERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
2222 BANCROFT WAY, #4300, BERKELEY, CA 94720-4300
(510) 934-6255
Mailing address
2222 BANCROFT WAY SPC 4300, BERKELEY, CA 94720-4300
(510) 934-6255

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
103TC1900X
Counseling Psychologist
Primary
28984
CA

Other

Enumeration date
06/24/2014
Last updated
03/12/2025
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