JAIME NISENBAUM

SAN RAFAEL, CA
NPI1902114523
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy103T00000X Psychologist
(Licence: CA  PSY 23623)
Additional Taxonomies103TC0700X Psychologist, Clinical
(Licence: CA  PSY 23623)
103TC1900X Psychologist, Counseling
(Licence: CA  PSY 23623)
Enumeration Date2010-09-16
Last Update Date2010-09-16
Business Address
Dr. JAIME NISENBAUM Ph.D.
711 D ST STE 201
SAN RAFAEL, CA 94901-3704
Phone number: 415-516-0797
Mailing Address
Dr. JAIME NISENBAUM Ph.D.
1 LONGVIEW AVE
SAN ANSELMO, CA 94960-2325
Phone number: 415-516-0797