Provider Demographics
NPI:1578638995
Name:CURTIS, JUDY (PSYD, LMFT)
Entity type:Individual
Prefix:DR
First Name:JUDY
Middle Name:
Last Name:CURTIS
Suffix:
Gender:F
Credentials:PSYD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1968 GOULDIN RD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-2242
Mailing Address - Country:US
Mailing Address - Phone:510-260-2411
Mailing Address - Fax:510-260-2412
Practice Address - Street 1:1530 5TH ST
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94710-1713
Practice Address - Country:US
Practice Address - Phone:510-260-2411
Practice Address - Fax:510-260-2412
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC31741106H00000X
CAPSY 25966103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist