Provider Demographics
NPI:1275654824
Name:GAISER, PAUL FREDERICK (PSYD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:FREDERICK
Last Name:GAISER
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 1:230 GRAND AVE
Mailing Address - Street 2:#304
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610-4589
Mailing Address - Country:US
Mailing Address - Phone:510-286-7619
Mailing Address - Fax:
Practice Address - Street 1:230 GRAND AVE
Practice Address - Street 2:#304
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94610-4589
Practice Address - Country:US
Practice Address - Phone:510-286-7619
Practice Address - Fax:510-533-0300
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17324106H00000X
CA20325103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist