Provider Demographics
NPI:1528194032
Name:MUIR, JAMES JEFFREY (PHD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:JEFFREY
Last Name:MUIR
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 DWIGHT WAY
Mailing Address - Street 2:ABSMC HERRICK, 5 NORTH REHABILITATION
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94704-2608
Mailing Address - Country:US
Mailing Address - Phone:510-204-4570
Mailing Address - Fax:510-204-4655
Practice Address - Street 1:2001 DWIGHT WAY
Practice Address - Street 2:ABSMC HERRICK, 5 NORTH REHABILITATION
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94704-2608
Practice Address - Country:US
Practice Address - Phone:510-204-4570
Practice Address - Fax:510-204-4655
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY19882103G00000X, 103TC0700X, 103TR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation