(510) 788-0005
[email protected]
Coming Soon
Coming soon
What type of appointment would you like to schedule?* IndividualCouplesFamilyMinor (11-18)Minor (7-11)
Would you like to schedule for virtual or in person?* in personvideo appointmentseither
Your Name*
Your Email*
Guardian Name(s) if client is under 18, N/A if 18+ - if for couples therapy provide partner's name*
Your Phone Number*
Your Insurance information* SHIPAnthem Blue Cross (not the same as Blue Shield)Medicare (not the same as Medi-Cal)Out of Network/PPOPrivate PayOther
Your insurance ID and group number (This helps us verify benefits)
Patient Date of Birth*
Do you have a therapist preference? —Please choose an option—Brian Sedgeley, PsyDKathleen Wonacott, LCSWKristy Shanks, LCSWTamara Lipton, LMFTMarisa Gordon, LMFT
Additional information*