Provider Demographics
NPI:1750301313
Name:MAX, DAVID N (PHD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:N
Last Name:MAX
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2 ADMIRAL DR
Mailing Address - Street 2:APT. 281
Mailing Address - City:EMERYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94608-1550
Mailing Address - Country:US
Mailing Address - Phone:510-428-1671
Mailing Address - Fax:510-428-1911
Practice Address - Street 1:315 SANCHEZ ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-1615
Practice Address - Country:US
Practice Address - Phone:510-428-1671
Practice Address - Fax:510-428-1911
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPSY12368103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist