Provider Demographics
NPI:1376699793
Name:DIKMAN, ZIYA V (PHD)
Entity Type:Individual
Prefix:DR
First Name:ZIYA
Middle Name:V
Last Name:DIKMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:250 BON AIR RD
Mailing Address - Street 2:COMMUNITY MENTAL HEALTH - STAR PROGRAM
Mailing Address - City:GREENBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94904-1702
Mailing Address - Country:US
Mailing Address - Phone:415-473-2725
Mailing Address - Fax:415-507-4160
Practice Address - Street 1:250 BON AIR RD
Practice Address - Street 2:COMMUNITY MENTAL HEALTH - STAR PROGRAM
Practice Address - City:GREENBRAE
Practice Address - State:CA
Practice Address - Zip Code:94904-1702
Practice Address - Country:US
Practice Address - Phone:415-473-2725
Practice Address - Fax:415-507-4160
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20936103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist