Provider Demographics
NPI:1083231773
Name:OPEN DOORS THERAPY, A PSYCHOLOGICAL CORPORATION
Entity Type:Organization
Organization Name:OPEN DOORS THERAPY, A PSYCHOLOGICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:OSWALD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:650-681-1548
Mailing Address - Street 1:580 ARASTRADERO RD APT 603
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306-3947
Mailing Address - Country:US
Mailing Address - Phone:650-681-1548
Mailing Address - Fax:650-681-1552
Practice Address - Street 1:260 SHERIDAN AVE STE B10
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-2042
Practice Address - Country:US
Practice Address - Phone:650-681-1548
Practice Address - Fax:650-681-1552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-29
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty