| Doctor Name: | DR. JACQUELINE GREY ETEMAD |
| NPI Number: | 1396032363 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | A21746 |
| Business Practice Address: | 15 Venado Dr Tiburon, CA - 949201634 |
| Business Phone Number: | 4154352776 |
| Business Fax Number: | 4154359415 |
| Mailing Address: | 15 Venado Dr, TIBURON |
| State: | CA |
| Postal Code: | 949201634 |
| Phone Number: | 4154352776 |
| Fax Number: | 4154359415 |
| NPI Enumeration Date: | 06/29/2011 |
| NPI Last Update Date: | 06/29/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2084P0804X |
| License Number: | A21746 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Psychiatry & Neurology |
| Taxonomy Specialization: | Child & Adolescent Psychiatry |
| Taxonomy Definition: | Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |