Provider Demographics
NPI:1740902360
Name:MERIT PSYCHOLOGY GROUP, A PROFESSIONAL PSYCHOLOGY CORPORATION
Entity type:Organization
Organization Name:MERIT PSYCHOLOGY GROUP, A PROFESSIONAL PSYCHOLOGY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:ADRIENNE
Authorized Official - Middle Name:
Authorized Official - Last Name:DIFABIO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:650-960-5150
Mailing Address - Street 1:2439 BIRCH ST STE 8
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306-1946
Mailing Address - Country:US
Mailing Address - Phone:650-960-5150
Mailing Address - Fax:510-443-1369
Practice Address - Street 1:2439 BIRCH ST STE 8
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-1946
Practice Address - Country:US
Practice Address - Phone:650-960-5150
Practice Address - Fax:510-443-1369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty