Provider Demographics
NPI:1548380595
Name:BRASS, ESTHER REBECCA (PHD)
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:REBECCA
Last Name:BRASS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:ESTHER
Other - Middle Name:
Other - Last Name:BRASS-CHORIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1235 MARIN AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:CA
Mailing Address - Zip Code:94706-2042
Mailing Address - Country:US
Mailing Address - Phone:510-524-0456
Mailing Address - Fax:510-525-2403
Practice Address - Street 1:1235 MARIN AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:CA
Practice Address - Zip Code:94706-2042
Practice Address - Country:US
Practice Address - Phone:510-524-0456
Practice Address - Fax:510-525-2403
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY5696103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist