Provider Demographics
NPI:1982629986
Name:GREENBERG, AMY
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:GREENBERG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1260 B ST
Mailing Address - Street 2:SUITE 240
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-2955
Mailing Address - Country:US
Mailing Address - Phone:925-989-9826
Mailing Address - Fax:
Practice Address - Street 1:4698 SHEARWATER RD
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-4612
Practice Address - Country:US
Practice Address - Phone:925-989-9826
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 36752106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist