Provider Demographics
NPI:1962633263
Name:NADLER, ERIC NORMAN (PHD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:NORMAN
Last Name:NADLER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 MONTECILLO ROAD, MOB2
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903
Mailing Address - Country:US
Mailing Address - Phone:415-444-4860
Mailing Address - Fax:415-444-4011
Practice Address - Street 1:99 MONTECILLO RD., MOB 2
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903
Practice Address - Country:US
Practice Address - Phone:415-444-4860
Practice Address - Fax:415-444-4011
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-04
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 23843103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist