Provider Demographics
NPI:1669477949
Name:SAXTON, PAUL M (PHD, LCSW)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:M
Last Name:SAXTON
Suffix:
Gender:M
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2220 MOUNTAIN BLVD
Mailing Address - Street 2:STE 240
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-2905
Mailing Address - Country:US
Mailing Address - Phone:510-531-0220
Mailing Address - Fax:
Practice Address - Street 1:2220 MOUNTAIN BLVD
Practice Address - Street 2:STE 240
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-2905
Practice Address - Country:US
Practice Address - Phone:510-531-0220
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS32211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical