Provider Demographics
NPI:1033512348
Name:BYRD, DERECK HR (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DERECK
Middle Name:HR
Last Name:BYRD
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4096 PIEDMONT AVE # 185
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-5221
Mailing Address - Country:US
Mailing Address - Phone:510-982-1000
Mailing Address - Fax:510-210-9310
Practice Address - Street 1:2961 SUMMIT ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3482
Practice Address - Country:US
Practice Address - Phone:510-982-1000
Practice Address - Fax:510-210-9310
Is Sole Proprietor?:No
Enumeration Date:2014-09-30
Last Update Date:2019-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health