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Individual

DR. ANNEMIEKE DE JONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
2171 UNION ST, SUITE 4, SAN FRANCISCO, CA 94123-4003
(415) 346-8144
Mailing address
2171 UNION ST, SUITE 4, SAN FRANCISCO, CA 94123-4003
(415) 346-8144

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY15584
CA
103TC0700X
Clinical Psychologist
PSY15584
CA
103TC2200X
Clinical Child & Adolescent Psychologist
PSY15584
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0PL155840
BLUE SHIELD
CA
01
188081
MANAGED HEATLTH NETWORK
CA
Enumeration date
08/30/2006
Last updated
09/11/2025
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