NPI 1083194674 · live from the CMS NPI Registry
A Sober Choice
Psychologist, Clinical in San Leandro, CA. National Provider Identifier 1083194674, active.
NPI record
| NPI | 1083194674 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Psychologist, Clinical 103TC0700X |
| Practice location | 1271 Washington Ave, San Leandro, CA 94577 |
| Practice phone | 510-610-9360 |
| Mailing address | 1271 Washington Ave # 445, San Leandro, CA 94577 |
| Enumerated | August 14, 2018 |
| Last updated | August 15, 2024 |
| Authorized official | Najjuma Shurn, President/Ceo |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychologist, Clinical primary | 103TC0700X | PSY27577 (CA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.