Provider Demographics
NPI:1053529263
Name:RAISMAN, ARTHUR ROBERT (PHD)
Entity type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:ROBERT
Last Name:RAISMAN
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 1:5 SCHAAF CT
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94901-1045
Mailing Address - Country:US
Mailing Address - Phone:415-453-4271
Mailing Address - Fax:
Practice Address - Street 1:5 SCHAAF CT
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-1045
Practice Address - Country:US
Practice Address - Phone:415-453-4271
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY7795103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist