Provider Demographics
NPI:1851799274
Name:PISMAN, MAEGAN DANIELLE (PHD)
Entity Type:Individual
Prefix:DR
First Name:MAEGAN
Middle Name:DANIELLE
Last Name:PISMAN
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 1:301 KING ST UNIT 510
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94158-1654
Mailing Address - Country:US
Mailing Address - Phone:510-560-6393
Mailing Address - Fax:833-561-2393
Practice Address - Street 1:301 KING ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94158-1634
Practice Address - Country:US
Practice Address - Phone:510-560-6393
Practice Address - Fax:833-561-2393
Is Sole Proprietor?:No
Enumeration Date:2014-12-17
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
ORB10195682103K00000X
WABA60882707103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst