Provider Demographics
NPI:1063820546
Name:RAZEK, RULA (PSYD)
Entity Type:Individual
Prefix:
First Name:RULA
Middle Name:
Last Name:RAZEK
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:RULA
Other - Middle Name:
Other - Last Name:RAZEK KLEE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:5655 COLLEGE AVE STE 318B
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94618-1672
Mailing Address - Country:US
Mailing Address - Phone:510-292-4930
Mailing Address - Fax:
Practice Address - Street 1:5655 COLLEGE AVE STE 318B
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94618-1672
Practice Address - Country:US
Practice Address - Phone:510-292-4930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-28
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY32806103TC0700X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical