Provider Demographics
NPI:1518312776
Name:ALEPH PSYCHOLOGICAL SERVICES, INC.
Entity Type:Organization
Organization Name:ALEPH PSYCHOLOGICAL SERVICES, INC.
Other - Org Name:THE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRITNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BLAIR
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, CBSM
Authorized Official - Phone:415-843-1523
Mailing Address - Street 1:912 COLE ST # 368
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94117-4316
Mailing Address - Country:US
Mailing Address - Phone:650-843-1523
Mailing Address - Fax:415-484-7083
Practice Address - Street 1:512 HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-2011
Practice Address - Country:US
Practice Address - Phone:415-843-1523
Practice Address - Fax:415-484-7083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-25
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY25823103T00000X
CAPSY27682103T00000X
CAPSY18633103T00000X
CA26102103T00000X
CAPSY28205103TB0200X
CAA1324452084P0800X
CAA1391892084P0800X
CAA1104492084P0800X
CAA1381392084P0800X
CAA1319732084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty