Individual
DR. ANKA LASZLO PAINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
412 RED HILL AVE, SUITE 4, SAN ANSELMO, CA 94960-2450
(415) 302-7305
Mailing address
33 LOCUST AVE, LARKSPUR, CA 94939-1366
(415) 302-7305
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
20691
CA
103TC1900X
Counseling Psychologist
20691
CA
103TC2200X
Clinical Child & Adolescent Psychologist
20691
—
103TF0000X
Family Psychologist
20691
—
Other
Enumeration date
02/15/2012
Last updated
02/15/2012
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