Provider Demographics
NPI:1386633725
Name:HALPERT, STEPHEN CHARLES (PSYD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:CHARLES
Last Name:HALPERT
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 1:2991 SHATTUCK AVE
Mailing Address - Street 2:SUITE 303
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-1870
Mailing Address - Country:US
Mailing Address - Phone:510-848-2921
Mailing Address - Fax:509-753-6121
Practice Address - Street 1:2991 SHATTUCK AVE
Practice Address - Street 2:SUITE 303
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-1870
Practice Address - Country:US
Practice Address - Phone:510-848-2921
Practice Address - Fax:509-753-6121
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY17953103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical