| Tlc Behavioral Health And Psychology Corporation | |
|
1080 Marina Village Parkway Suite 100 Alameda CA 94501-1078 | |
| (510) 337-7950 | |
| (510) 337-7969 |
| Full Name | Tlc Behavioral Health And Psychology Corporation |
|---|---|
| Speciality | Psychologist - Health Service |
| Location | 1080 Marina Village Parkway, Alameda, California |
| Authorized Official Name and Position | Michael Wiederstein (CEO, CFO) |
| Authorized Official Contact | 5103377950 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tlc Behavioral Health And Psychology Corporation 1080 Marina Village Parkway Suite 100 Alameda CA 94501-1078 Ph: (510) 337-7950 | Tlc Behavioral Health And Psychology Corporation 1080 Marina Village Parkway Suite 100 Alameda CA 94501-1078 Ph: (510) 337-7950 |
| NPI Number | 1538556865 |
|---|---|
| Provider Enumeration Date | 04/24/2015 |
| Last Update Date | 05/10/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538556865 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TH0100X | Psychologist - Health Service | (* (Not Available)) | Primary |
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