Provider Demographics
NPI:1073177713
Name:BAY AREA COGNITIVE HEALTH, A PSYCHOLOGY CORPORATION
Entity Type:Organization
Organization Name:BAY AREA COGNITIVE HEALTH, A PSYCHOLOGY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:MARREIRO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:650-770-2224
Mailing Address - Street 1:533 AIRPORT BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-2013
Mailing Address - Country:US
Mailing Address - Phone:650-770-2224
Mailing Address - Fax:650-770-2223
Practice Address - Street 1:533 AIRPORT BLVD
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-2018
Practice Address - Country:US
Practice Address - Phone:650-770-2224
Practice Address - Fax:650-770-2223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-29
Last Update Date:2019-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty