Individual
LIZA BATHORI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
1101 S WINCHESTER BLVD, SUITE C-120, SAN JOSE, CA 95128-3901
(408) 654-9311
Mailing address
467 HAMILTON AVE, SUITE 22, PALO ALTO, CA 94301-1830
(650) 323-1676
(650) 323-1277
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PSY#20160
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
EIN:94-3120231
EASTER SEALS BAY AREA
CA
Enumeration date
02/22/2007
Last updated
07/20/2012
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