Provider Demographics
NPI:1164658324
Name:ZILS, MATTHEW JOSEPH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:JOSEPH
Last Name:ZILS
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 1:2001 JUNIPERO SERRA BLVD STE 650
Mailing Address - Street 2:KAISER PERMANENTE SSF, DEPT. OF PSYCHIATRY
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94014-3897
Mailing Address - Country:US
Mailing Address - Phone:650-991-6147
Mailing Address - Fax:
Practice Address - Street 1:2001 JUNIPERO SERRA BLVD STE 650
Practice Address - Street 2:KAISER PERMANENTE SSF, DEPT. OF PSYCHIATRY
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94014-3897
Practice Address - Country:US
Practice Address - Phone:650-991-6147
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-02
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY22693103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent