Green Psychotherapy, PC

NPI #1366001034 in Berkeley, California

Provider Information

NPI Number: 1366001034
Entity Type: Organization
Organization Name: Green Psychotherapy, PC
Primary Specialty: Psychologist - Clinical
Enumeration Date: Jun 6, 2019
Last Updated: Jan 12, 2020

Practice Location

Address: 2041 BANCROFT WAY STE 202
City: Berkeley
State: California
ZIP Code: 94704-1443
Phone: (510) 612-0097

Authorized Official

Name: DR. DOUGLAS VAKOCH, PH.D.
Title: CHIEF EXECUTIVE OFFICER
Phone: (510) 612-0097

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist	103T00000X
Psychologist - Clinical — Clinical	103TC0700X	Primary

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