1013633148 NPI number — TRANSCEND PSYCHOTHERAPY

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013633148 NPI number — TRANSCEND PSYCHOTHERAPY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TRANSCEND PSYCHOTHERAPY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1013633148
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/19/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1124 EL CAMINO REAL APT 9
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BURLINGAME
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94010-4945
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
510-541-4837
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1117 S B ST STE 4
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN MATEO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94401-4351
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-541-4837
Provider Business Practice Location Address Fax Number:
650-431-2157
Provider Enumeration Date:
10/19/2022

Additional Information

Authorized Official

Authorized Official Last Name:
MURPHY
Authorized Official First Name:
PATRICK
Authorized Official Middle Name:
M
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
510-541-4837

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1396003752 . This is a "NPPES" identifier . This identifiers is of the category "OTHER".




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