Basic Information
| Provider Information | |||||||||
| NPI: | 1619357423 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | UNIVERSITY OF CALIFORNIA COUNSELING AND PSYCHOLOGICAL SERVICES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2001 W 6TH ST | ||||||||
| Address2: | APT. G2 | ||||||||
| City: | LAWRENCE | ||||||||
| State: | KS | ||||||||
| PostalCode: | 660441755 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7125792873 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2222 BANCROFT WAY | ||||||||
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| City: | BERKELEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 947204301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5106422000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/05/2015 | ||||||||
| LastUpdateDate: | 06/05/2015 | ||||||||
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| AuthorizedOfficialLastName: | SCHECHINGER | ||||||||
| AuthorizedOfficialFirstName: | HEATH | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | PRE-DOCTORAL INTERN | ||||||||
| AuthorizedOfficialTelephone: | 7125792873 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.S., M.ED. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.