Provider Demographics
NPI:1679302640
Name:GOLDEN STATE TMS NEUROPSYCHOLOGICAL SERVICES
Entity type:Organization
Organization Name:GOLDEN STATE TMS NEUROPSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBYNNE
Authorized Official - Middle Name:
Authorized Official - Last Name:OBYRNE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:415-457-1910
Mailing Address - Street 1:750 LAS GALLINAS AVE STE 117
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903-3431
Mailing Address - Country:US
Mailing Address - Phone:415-991-6959
Mailing Address - Fax:
Practice Address - Street 1:750 LAS GALLINAS AVE STE 117
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-3431
Practice Address - Country:US
Practice Address - Phone:415-991-6959
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologist