Provider Demographics
NPI:1316146749
Name:VERDUN, MATTHEW (PSYD)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:VERDUN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 HARRISON ST STE 1100
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-3648
Mailing Address - Country:US
Mailing Address - Phone:510-470-4900
Mailing Address - Fax:
Practice Address - Street 1:3970 CASTRO VALLEY BLVD SPACE 1
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546
Practice Address - Country:US
Practice Address - Phone:510-470-4900
Practice Address - Fax:424-204-0391
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-16
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT85437106H00000X
CA33982103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist