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 | 103G00000X | Clinical Neuropsychologist | | PSY C19553 | CALIFORNIA | No |
| 2 | 103T00000X | Psychologist | | PSY 19553 | CALIFORNIA | No |
| 3 | 103TC0700X | Psychologist | Clinical | PSY 19553 | CALIFORNIA | No |
| 4 | 103TF0200X | Psychologist | Forensic | PSY 19553 | CALIFORNIA | No |
| 5 | 103TH0100X | Psychologist | Health Service | PSY 19553 | CALIFORNIA | No |
| 6 | 103TP2701X | Psychologist | Group Psychotherapy | PSY 19553 | CALIFORNIA | No |
| 7 | 103TR0400X | Psychologist | Rehabilitation | PSY 19553 | CALIFORNIA | No |
| 8 | 103TA0700X | Psychologist | Adult Development & Aging | PSY 19553 | CALIFORNIA | Yes |