Provider Demographics
NPI:1578883872
Name:MARKOWSKI, STANLEY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:
Last Name:MARKOWSKI
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5309 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94618-1416
Mailing Address - Country:US
Mailing Address - Phone:510-452-0833
Mailing Address - Fax:510-596-9030
Practice Address - Street 1:5309 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94618-1416
Practice Address - Country:US
Practice Address - Phone:510-452-0833
Practice Address - Fax:510-596-9030
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-09
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY27924103TC0700X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent