Provider Demographics
NPI:1992991988
Name:ANDERS, ERIC (PSYD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:
Last Name:ANDERS
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 1:119 WHITETHORNE DR
Mailing Address - Street 2:
Mailing Address - City:MORAGA
Mailing Address - State:CA
Mailing Address - Zip Code:94556-1736
Mailing Address - Country:US
Mailing Address - Phone:925-247-0559
Mailing Address - Fax:
Practice Address - Street 1:5625 COLLEGE AVE STE 216
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94618-1585
Practice Address - Country:US
Practice Address - Phone:510-486-8999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-24
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARP202102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst