TLC Behavioral Health and Psychology Corporation

Primary specialty

Health Service PsychologistTaxonomy code 103TH0100X

Legal business name

TLC BEHAVIORAL HEALTH AND PSYCHOLOGY CORPORATION

Practice address

1080 Marina Village Parkway
Suite 100
Alameda, CA 94501-1078

Phone

(510) 337-7950

Fax

(510) 337-7969

NPI assigned

Apr 24, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michael Wiederstein

Title

Ceo, Cfo

Phone

(510) 337-7950

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1429833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462838400000",
    "number": "1538556865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1080 MARINA VILLAGE PARKWAY",
            "address_2": "SUITE 100",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945011078",
            "telephone_number": "510-337-7950",
            "fax_number": "510-337-7969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1080 MARINA VILLAGE PARKWAY",
            "address_2": "SUITE 100",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945011078",
            "telephone_number": "510-337-7950",
            "fax_number": "510-337-7969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TLC BEHAVIORAL HEALTH AND PSYCHOLOGY CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-24",
        "last_updated": "2016-05-10",
        "status": "A",
        "authorized_official_last_name": "WIEDERSTEIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO, CFO",
        "authorized_official_telephone_number": "510-337-7950"
    },
    "taxonomies": [
        {
            "code": "103TH0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Twila Yvette Tillis
• Jonathan Lee Tillotson
• Lakeshia Nicole Timmons
• Paul H Ting, D.D.S.
• Charlotte Adele Tlachac, O.D.
• TMT Home Health Care
• Travis Lafayette Tolbert
• Malaysia Tolliver
• Michiah Ramaneque Toney
• Jane Tong Delore, L.AC.

• Health Service Psychologist in Alameda, CA
• Providers in Alameda, CA by specialty
• Health Service Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.