Individual
JONATHAN DAVID VASQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2020 MILVIA ST STE 450, BERKELEY, CA 94704-1297
(510) 214-2110
Mailing address
2020 MILVIA ST STE 450, BERKELEY, CA 94704-1297
(510) 214-3593
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
94029315
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/12/2024
Last updated
07/28/2026
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