Provider Demographics
NPI:1568976793
Name:DR. AYELET HIRSHFELD
Entity Type:Organization
Organization Name:DR. AYELET HIRSHFELD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER LICENSED CLINICAL PSYCHOLOGST
Authorized Official - Prefix:DR
Authorized Official - First Name:AYELET
Authorized Official - Middle Name:
Authorized Official - Last Name:HIRSHFELD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:408-874-6506
Mailing Address - Street 1:1101 S WINCHESTER BLVD STE G174
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-3917
Mailing Address - Country:US
Mailing Address - Phone:408-874-6506
Mailing Address - Fax:
Practice Address - Street 1:1101 S WINCHESTER BLVD STE G174
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-3917
Practice Address - Country:US
Practice Address - Phone:408-874-6506
Practice Address - Fax:408-663-6614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-27
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY22767103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1861687659OtherNPI