Mark David Ettensohn PSY.D.

NPI 1417147703 - Psychologist - 103T00000X

NPI Details
NPI 1417147703
Gender Male
Enumeration Date 08/01/2007
Last Updated 01/03/2013
Entity Type Individual
Active Over 9 years ago
Practice Location
835 UNIVERSITY AVE
SACRAMENTO CA, 95825-6724, US
Phone (916) 538-3019
Fax
Business Location
835 UNIVERSITY AVE
SACRAMENTO CA, 95825-6724, US
Phone (916) 538-3019
Fax
Toxanomy
Taxonomy Code 103T00000X
License State California
License Number PSY 25461
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According to our database, Dr. Mark David Ettensohn PSY.D. NPI is 1417147703, taxonomy code is 103T00000X and license number is PSY 25461, license state is located at California. Mark David Ettensohn PSY.D. physically located at 835 University Ave, Sacramento CA, 95825-6724. NPI Number Mark David Ettensohn PSY.D. has the Individual type.

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1417147703 NPI number is provided on an as is basis without warranty of any kind. 1417147703 is maintained by the National Plan & Provider Enumeration System. The contents of Mark David Ettensohn PSY.D. are for informational purposes only.