Provider Demographics
NPI:1982829305
Name:NEWMAN, GILBERT H (PHD)
Entity Type:Individual
Prefix:
First Name:GILBERT
Middle Name:H
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2728 DURANT AVE
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94704-1725
Mailing Address - Country:US
Mailing Address - Phone:510-484-5669
Mailing Address - Fax:510-841-0167
Practice Address - Street 1:2728 DURANT AVE
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94704
Practice Address - Country:US
Practice Address - Phone:510-484-5669
Practice Address - Fax:510-841-0167
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY17179103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY17179OtherCALIF LIC