Dr. Mark Douglas Breithaupt
Psychologist Clinical Psychologist Addiction Psychologist (Substance Use Disorder)
1100 Lincoln Ave Ste 394
San Jose
, California 95125
Dr. Mark Douglas Breithaupt
Psychologist Clinical Psychologist Addiction Psychologist (Substance Use Disorder)
1100 Lincoln Ave Ste 394
San Jose
, California 95125
(408) 320-2747
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About
Features
Specialties
- Psychologist
- Addiction Psychologist (Substance Use Disorder)
- Clinical Psychologist
Languages spoken
- English
Location
First Address
- Dr. Mark Douglas Breithaupt
- Po Box 8396
- San Jose, CA
- Zip : 95155-8396
- Fax : (408) 320-2747
- Phone : (408) 320-2747
Second Address
- Dr. Mark Douglas Breithaupt
- 1100 Lincoln Ave Ste 394
- San Jose, CA
- Zip : 95125
- Fax : (408) 320-2747
- Phone : (408) 320-2747
Reviews
FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 102L00000X | Psychologist | PSY 499 | HI |
| N | 103T00000X | Psychologist | PSY 499 | HI |
| N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | ||
| Y | 103G00000X | Clinical Psychologist | PSY 499 | HI |
| Y | 103TC0700X | Clinical Psychologist | PSY 499 | HI |
National Provider Identifier
| NPI | 1053436337 |
|---|---|
| Provider Name | Dr. Mark Douglas Breithaupt |
| First Address | San Jose, CA 95155-8396 |
| Second Address | San Jose, CA 95125 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 19/03/2007 |
| Last Update Date | 09/09/2019 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 03451701 | (05) | HI |
| A 3812-3 | HMSA (01) | HI |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.