Provider Demographics
NPI:1750533238
Name:ANDERSON, ABBY VICTORIA (PSYD)
Entity type:Individual
Prefix:DR
First Name:ABBY
Middle Name:VICTORIA
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 SAINT LOUIS LN
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-1139
Mailing Address - Country:US
Mailing Address - Phone:925-348-2822
Mailing Address - Fax:
Practice Address - Street 1:3000 CITRUS CIR
Practice Address - Street 2:SUITE 112
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2663
Practice Address - Country:US
Practice Address - Phone:925-348-2822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-16
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 21959103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist