Provider Demographics
NPI:1851560544
Name:MAREK, WILLIAM KEITH (PHD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:KEITH
Last Name:MAREK
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 REFLECTIONS DR
Mailing Address - Street 2:APT. 18
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-4709
Mailing Address - Country:US
Mailing Address - Phone:925-275-0294
Mailing Address - Fax:925-426-0094
Practice Address - Street 1:105 REFLECTIONS DR
Practice Address - Street 2:APT. 18
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-4709
Practice Address - Country:US
Practice Address - Phone:925-275-0294
Practice Address - Fax:925-426-0094
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-27
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 14791103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist