Provider Demographics
NPI:1558587212
Name:GLINDER, JUDITH GAIL (PHD)
Entity Type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:GAIL
Last Name:GLINDER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1971 MENALTO AVE
Mailing Address - Street 2:
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-2834
Mailing Address - Country:US
Mailing Address - Phone:650-380-4663
Mailing Address - Fax:650-352-5555
Practice Address - Street 1:467 HAMILTON AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-1830
Practice Address - Country:US
Practice Address - Phone:650-352-5555
Practice Address - Fax:650-352-5555
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 19053103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral