Provider Demographics
NPI:1801837760
Name:TRUE, REIKO (PHD)
Entity Type:Individual
Prefix:
First Name:REIKO
Middle Name:
Last Name:TRUE
Suffix:
Gender:F
Credentials:PHD
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Mailing Address - Street 1:5326 SILVA AVE
Mailing Address - Street 2:
Mailing Address - City:EL CERRITO
Mailing Address - State:CA
Mailing Address - Zip Code:94530-1432
Mailing Address - Country:US
Mailing Address - Phone:510-233-2082
Mailing Address - Fax:510-233-2997
Practice Address - Street 1:1801 BUSH ST
Practice Address - Street 2:SUITE 131-B
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-5239
Practice Address - Country:US
Practice Address - Phone:415-346-3495
Practice Address - Fax:510-233-2997
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPSY5412103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY5412OtherCLINICAL PSYCHOLOGY
CAPSY5412OtherCLINICAL PSYCHOLOGY