Provider Demographics
NPI:1871826487
Name:LIVINGSTONE, ANINHA ESPERANZA (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANINHA
Middle Name:ESPERANZA
Last Name:LIVINGSTONE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:ANINHA
Other - Middle Name:
Other - Last Name:ESPERANZA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA
Mailing Address - Street 1:PO BOX 642
Mailing Address - Street 2:
Mailing Address - City:FOREST KNOLLS
Mailing Address - State:CA
Mailing Address - Zip Code:94933-0642
Mailing Address - Country:US
Mailing Address - Phone:415-717-6441
Mailing Address - Fax:415-295-7395
Practice Address - Street 1:700 E ST SAN RAFAEL CA 94901
Practice Address - Street 2:SUITE 201
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901
Practice Address - Country:US
Practice Address - Phone:154-717-6441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-14
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY27953103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical