Provider Demographics
NPI:1891835302
Name:FORESTER, CRESSIDA A (PSY D)
Entity Type:Individual
Prefix:DR
First Name:CRESSIDA
Middle Name:A
Last Name:FORESTER
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1352
Mailing Address - Street 2:
Mailing Address - City:BOYES HOT SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:95416-1352
Mailing Address - Country:US
Mailing Address - Phone:415-409-0388
Mailing Address - Fax:
Practice Address - Street 1:710 WEST NAPA ST
Practice Address - Street 2:STE 2
Practice Address - City:SONOMA
Practice Address - State:CA
Practice Address - Zip Code:95476
Practice Address - Country:US
Practice Address - Phone:707-934-7659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 18902103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist