Provider Demographics
NPI:1285808915
Name:BISEK, ANNE M (PSYD)
Entity type:Individual
Prefix:DR
First Name:ANNE
Middle Name:M
Last Name:BISEK
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3602 THORNTON AVE # 54
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94536-7400
Mailing Address - Country:US
Mailing Address - Phone:510-797-4911
Mailing Address - Fax:510-797-4911
Practice Address - Street 1:3602 THORNTON AVE # 54
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94536-7400
Practice Address - Country:US
Practice Address - Phone:510-797-4911
Practice Address - Fax:510-797-4911
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-14
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY21650103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist