Provider Demographics
NPI:1235741786
Name:SHARON J. TYSON, PH.D. AND DAVID J. FRANKEL, PH.D. A PSYCHOLOGY CORPOR
Entity Type:Organization
Organization Name:SHARON J. TYSON, PH.D. AND DAVID J. FRANKEL, PH.D. A PSYCHOLOGY CORPOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:JOAN
Authorized Official - Last Name:TYSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:510-525-8420
Mailing Address - Street 1:2000 HEARST AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94709-2260
Mailing Address - Country:US
Mailing Address - Phone:510-525-8420
Mailing Address - Fax:
Practice Address - Street 1:1505 SOLANO AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:CA
Practice Address - Zip Code:94707-2106
Practice Address - Country:US
Practice Address - Phone:510-525-8420
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1639383656OtherNPI
CA1104251719OtherNPI