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 | 2084A0401X | Psychiatry & Neurology | Addiction Medicine | 10884 | OKLAHOMA | No |
| 2 | 2084A0401X | Psychiatry & Neurology | Addiction Medicine | C36830 | CALIFORNIA | No |
| 3 | 2084N0400X | Psychiatry & Neurology | Neurology | C36830 | CALIFORNIA | No |
| 4 | 2084A0401X | Psychiatry & Neurology | Addiction Medicine | 21634 | PUERTO RICO | No |
| 5 | 2084N0400X | Psychiatry & Neurology | Neurology | 10884 | OKLAHOMA | No |
| 6 | 2084N0400X | Psychiatry & Neurology | Neurology | 21634 | PUERTO RICO | No |
| 7 | 2084P0301X | Psychiatry & Neurology | Brain Injury Medicine | 10884 | OKLAHOMA | No |
| 8 | 2084P0800X | Psychiatry & Neurology | Psychiatry | 10884 | OKLAHOMA | No |
| 9 | 2084P0301X | Psychiatry & Neurology | Brain Injury Medicine | C36830 | CALIFORNIA | No |
| 10 | 2084P0301X | Psychiatry & Neurology | Brain Injury Medicine | 21634 | PUERTO RICO | No |
| 11 | 2084P0800X | Psychiatry & Neurology | Psychiatry | C36830 | CALIFORNIA | No |
| 12 | 2084P0800X | Psychiatry & Neurology | Psychiatry | 21634 | PUERTO RICO | No |
| 13 | 207NS0135X | Dermatology | Procedural Dermatology | 10884 | OKLAHOMA | Yes |
