Provider Demographics
NPI:1952641003
Name:ANDERS GREENWOOD, DOCTOR OF PSYCHOLOGY, INC.
Entity Type:Organization
Organization Name:ANDERS GREENWOOD, DOCTOR OF PSYCHOLOGY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDERS
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:GREENWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, PHD
Authorized Official - Phone:510-364-4825
Mailing Address - Street 1:1325 PARKINSON AVE
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94301-3453
Mailing Address - Country:US
Mailing Address - Phone:510-364-4825
Mailing Address - Fax:415-896-2511
Practice Address - Street 1:703 MARKET ST
Practice Address - Street 2:SUITE 410
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-2110
Practice Address - Country:US
Practice Address - Phone:510-364-4825
Practice Address - Fax:415-896-2511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-27
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 22009103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AW483Medicare UPIN