Individual
DR. ALI-REZA CHAVOSHIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
2955 SHATTUCK AVE, #1, BERKELEY, CA 94705-1808
(510) 845-2409
Mailing address
2728 DURANT AVE, BERKELEY, CA 94704-1725
(510) 845-2409
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
15984
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
762204
MEDICAL
CA
Enumeration date
02/05/2007
Last updated
07/08/2007
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