Provider Demographics
NPI:1548474901
Name:WEITZMAN, GERI DAWN (PHD)
Entity type:Individual
Prefix:DR
First Name:GERI
Middle Name:DAWN
Last Name:WEITZMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:941 E CHARLESTON RD
Mailing Address - Street 2:STE 103
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94303-4998
Mailing Address - Country:US
Mailing Address - Phone:408-338-5638
Mailing Address - Fax:
Practice Address - Street 1:941 E CHARLESTON RD
Practice Address - Street 2:STE 103
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94303-4998
Practice Address - Country:US
Practice Address - Phone:408-338-5638
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY17963103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling