Provider Demographics
NPI:1700142080
Name:HONIGMAN, AMY L (PHD)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:L
Last Name:HONIGMAN
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 1:1527 TRESTLE GLEN RD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610-1841
Mailing Address - Country:US
Mailing Address - Phone:510-421-0434
Mailing Address - Fax:
Practice Address - Street 1:5655 COLLEGE AVE
Practice Address - Street 2:SUITE 315
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94618-1583
Practice Address - Country:US
Practice Address - Phone:520-421-0434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-11
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY11755103TC0700X
103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical