Wald, Miriam S.

Wald, Miriam S. is an individual health care provider with primary practice located at 523 Hayes Ln , Petaluma CA 94952-4011. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Wald, Miriam S. can be contacted via phone (800) 257-8715.

Contact Information

Primary practice address
523 Hayes Ln Petaluma CA 94952-4011
Phone: (800) 257-8715
Fax: (800) 819-1655
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY10413 California

Profile Details

NPI number 1649352733
LBN Legal business name Wald, Miriam S.
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 19th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649352733 NPPES
California Other 0PL104130 BLUE CROSS BLUE SHIELD
California Other 680006644 BLUE CROSS BLUE SHIELD
California MEDICAID PSY104130 BLUE CROSS BLUE SHIELD

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