Provider Demographics
NPI:1841207289
Name:PARADOWSKI, PAMELA ANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:ANN
Last Name:PARADOWSKI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 NORBRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-5700
Mailing Address - Country:US
Mailing Address - Phone:510-433-9995
Mailing Address - Fax:877-350-3107
Practice Address - Street 1:1700 NORBRIDGE AVE
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-5700
Practice Address - Country:US
Practice Address - Phone:510-433-9955
Practice Address - Fax:877-350-3107
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY15053103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY150530Medicaid
CAOPL150530Medicare ID - Type Unspecified
CANPPOOOMedicare UPIN
CAPSY150530Medicaid