Provider Demographics
NPI:1609431980
Name:M.A. KATZ PSYCHOLOGICAL SERVICES, INC
Entity Type:Organization
Organization Name:M.A. KATZ PSYCHOLOGICAL SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:KATZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-989-5643
Mailing Address - Street 1:5078 S FORESTDALE CIR
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-8747
Mailing Address - Country:US
Mailing Address - Phone:925-989-5643
Mailing Address - Fax:
Practice Address - Street 1:830 HILLVIEW CT STE 260
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-4553
Practice Address - Country:US
Practice Address - Phone:925-989-5643
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-02
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty