Provider Demographics
NPI:1568799849
Name:PEARSON TRIMBACH, WILLOW (PSYD, LMFT, MT-BC)
Entity type:Individual
Prefix:
First Name:WILLOW
Middle Name:
Last Name:PEARSON TRIMBACH
Suffix:
Gender:F
Credentials:PSYD, LMFT, MT-BC
Other - Prefix:
Other - First Name:WILLOW
Other - Middle Name:
Other - Last Name:PEARSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2342 SHATTUCK AVE # 262
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94704-1517
Mailing Address - Country:US
Mailing Address - Phone:650-264-9975
Mailing Address - Fax:
Practice Address - Street 1:964 46TH ST APT 242
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94608-3452
Practice Address - Country:US
Practice Address - Phone:650-264-9975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-08
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50993106H00000X
CA29436103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist