Provider Demographics
NPI:1578600771
Name:SZPADZINSKI, RAYMOND STANLEY (MA MED MDIV MFT)
Entity Type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:STANLEY
Last Name:SZPADZINSKI
Suffix:
Gender:M
Credentials:MA MED MDIV MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 ARCH STREET
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94062-1303
Mailing Address - Country:US
Mailing Address - Phone:650-363-0249
Mailing Address - Fax:650-363-0436
Practice Address - Street 1:165 ARCH STREET
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94062-1303
Practice Address - Country:US
Practice Address - Phone:650-363-0249
Practice Address - Fax:650-363-0436
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301002183103T00000X
CAMFT27555106H00000X
MI4101005009106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist