Department Of State Hospitals

NPI 1043249204 - Psychologist - 103TF0200X

NPI Details
NPI 1043249204
Enumeration Date 07/01/2006
Last Updated 11/12/2013
Entity Type Healthcare Provider
Active Over 11 years ago
Authorized Information
Name MARK MARK
Position CHIEF DEPUTY DIRECTOR
Phone (909) 425-7552
Fax (909) 425-6407
Practice Location
3102 E HIGHLAND AVE
PATTON CA, 92369-7813, US
Phone (909) 425-7552
Fax (909) 425-6407
Business Location
1600 9TH STREET, ROOM 150
FISCAL ALLOCATIONS AND ESTIMATES UNIT
SACRAMENTO CA, 95814-6414, US
Phone (916) 651-9475
Fax (916) 651-8908
Toxanomy
Taxonomy Code 103TF0200X
License State California
License Number 170000831
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According to our database, Department Of State Hospitals NPI is 1043249204, taxonomy code is 103TF0200X and license number is 170000831, license state is located at California. Department Of State Hospitals physically located at 3102 E Highland Ave, Patton CA, 92369-7813. NPI Number 1033115704 has the healthcare provider type.

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1043249204 NPI number is provided on an as is basis without warranty of any kind. 1043249204 is maintained by the National Plan & Provider Enumeration System. The contents of Department Of State Hospitals are for informational purposes only.