Provider Demographics
NPI:1265628820
Name:NEDELISKY ZEMAN, ANNA (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:
Last Name:NEDELISKY ZEMAN
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 1:2104 HALE DR
Mailing Address - Street 2:
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-5514
Mailing Address - Country:US
Mailing Address - Phone:917-331-1503
Mailing Address - Fax:
Practice Address - Street 1:318 S B ST
Practice Address - Street 2:STE 5
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401-4029
Practice Address - Country:US
Practice Address - Phone:917-331-1503
Practice Address - Fax:650-763-9191
Is Sole Proprietor?:No
Enumeration Date:2007-09-18
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017719103TC0700X, 103G00000X
CAPSY26298103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist