Provider Demographics
NPI:1114361995
Name:STRUCHEN, MARGARET ANN (PHD)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:ANN
Last Name:STRUCHEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1922 TICE VALLEY BLVD UNIT 2817
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94595-5043
Mailing Address - Country:US
Mailing Address - Phone:281-546-4302
Mailing Address - Fax:
Practice Address - Street 1:2155 S BASCOM AVE STE 103
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-3200
Practice Address - Country:US
Practice Address - Phone:281-546-4302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-23
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30895103G00000X, 103TR0400X
CA30977103TR0400X, 103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation