Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 103T00000X | Psychologist | | PSY 19462 | CALIFORNIA | No |
| 2 | 103TC2200X | Psychologist | Clinical Child & Adolescent | PSY 19462 | CALIFORNIA | No |
| 3 | 103TC1900X | Psychologist | Counseling | PSY 19462 | CALIFORNIA | Yes |