Gail Barry Bourque in Berkeley - Clinical
Gail Barry Bourque - NPI 1962426312
Gail Barry Bourque is a Clinical in Berkeley, California. Gail Barry Bourque practices all healthcare services and medical treatments related to Clinical. The NPI Number for Gail Barry Bourque is 1962426312. The last update date is 2007-07-08.
Gail Barry Bourque's current location address is 2342 Shattuck Ave, Berkeley, California. You can contact this provider via phone number 5104337315 and fax number 5108488343. The mailing address for Gail Barry Bourque is 2342 Shattuck Ave, Berkeley, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Gail Barry Bourque |
|---|---|
| Address | 2342 Shattuck Ave, Berkeley, California |
| Phone Number | 5104337315 |
| Fax Number | 5108488343 |
| Sole Proprietor | Y |
| Credentials | PSY.D. |
NPI Number Detail
| NPI Number | 1962426312 |
|---|---|
| Provider Enumeration Date | 2006-07-27 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 2342 Shattuck Ave |
|---|---|
| City | Berkeley |
| State | California (CA) |
| Post Code | 947041517 |
| Phone Number | 5104337315 |
| Fax Number | 5108488343 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | PSY18020 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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What is the unique 10-digit identifier code assigned to Gail Barry Bourque by the Centers for Medicare & Medicaid Services?
The Gail Barry Bourque has been issued the NPI (National Provider Identifier) 1962426312 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Can you provide the Gail Barry Bourque's physical address?
The Gail Barry Bourque is physically located at 2342 Shattuck Ave, in the city of Berkeley, CA, with the postal code 947041517.
What is Gail Barry Bourque's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Gail Barry Bourque is Clinical, and the taxonomy code that classifies this field of practice is 103Tc0700X.
On what date did the Centers for Medicare & Medicaid Services issue the 1962426312 to Gail Barry Bourque?
The Gail Barry Bourque received its 1962426312 assignment from the Centers for Medicare & Medicaid Services on 2006-07-27.
As of what date were the details pertaining to Gail Barry Bourque last refreshed?
The information related to the Gail Barry Bourque, including its address, specialty, and other relevant details, was last updated on 2007-07-08.