Robert Avenson, PH.D.
Individual provider Active NPI Clinical Psychologist · Albany, CA
NPI 1487725792 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1487725792
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PL 10033 (CA)
- Practice address
- 1035 San Pablo Ave
Suite 5
Albany, CA 94706-2275 - Phone
- (510) 527-9767
- NPI assigned
- Nov 10, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PL 10033 | CA | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PL 10033 | CA | Yes |
Addresses
Primary practice location
1035 San Pablo Ave
Suite 5
Albany, CA 94706-2275
Mailing address
PO Box 764
Ross, CA 94957-0764
Phone (510) 527-9767
Other providers in Albany, CA
- Heidi P Aronson
- Rosana Ascanio
- Michelle Asesltine
- Tracy Lynn Ashlock
- Aileen D Auyeung
- Nia Olin Baarsch
- Jennifer Badde
- Tiffany Baer
- Annie N Bailey
- Shelly D Ball
All providers in Albany, CA · Clinical Psychologist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.