Provider Demographics
NPI:1427156850
Name:NAAS, MARK R (PSY)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:R
Last Name:NAAS
Suffix:
Gender:M
Credentials:PSY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 41ST STREET
Mailing Address - Street 2:P.O. BOX 11214
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611
Mailing Address - Country:US
Mailing Address - Phone:925-203-5810
Mailing Address - Fax:
Practice Address - Street 1:3873 PIEDMONT AVE STE 2
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-5367
Practice Address - Country:US
Practice Address - Phone:925-203-5810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY19156103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist