05D1065614 CLIA NUMBER - PENINSULA HEALTHCARE CONNECTION

Laboratory Demographics

CLIA Number: 05D1065614

Facility Name: PENINSULA HEALTHCARE CONNECTION

Facility Address:
33 ENCINO AVE STE 103
PALO ALTO, CA
ZIP 94301
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Facility Phone Number: (650) 853-0321

Facility Type: COMMUNITY CLINIC

Certificate Type: Waiver

NPI Number: 1316494883

Taxonomy: 103TC0700X - Psychologist
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

CLIA Record

Field Name	Field Value
CLIA Number	05D1065614
LAB Type	COMMUNITY CLINIC
Facility Name	PENINSULA HEALTHCARE CONNECTION
Street	33 ENCINO AVE STE 103
City	PALO ALTO
State	CA
ZIP	94301
Phone	(650) 853-0321

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This page was last updated on: 5/11/2023