Provider Demographics
NPI:1497170088
Name:SZYMANSKI, MICHAEL
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:SZYMANSKI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 SANTA GABRIELLA CT
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94945-1121
Mailing Address - Country:US
Mailing Address - Phone:415-913-9332
Mailing Address - Fax:
Practice Address - Street 1:3270 KERNER BLVD STE A
Practice Address - Street 2:SAN RAFAEL, CA 94901
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-4840
Practice Address - Country:US
Practice Address - Phone:415-456-9350
Practice Address - Fax:415-456-1508
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-19
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health