Doctor Name: | KIRSTEN MARCEL |
NPI Number: | 1003983495 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSY.D. |
License Number: | PSY 20465 |
Business Practice Address: | 290 I O O F Ave Gilroy, CA - 950205204 |
Business Phone Number: | 4088462100 |
Business Fax Number: | |
Mailing Address: | 290 I O O F Ave, GILROY |
State: | CA |
Postal Code: | 950205204 |
Phone Number: | 4088462100 |
Fax Number: | |
NPI Enumeration Date: | 11/29/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC2200X |
License Number: | PSY 20465 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical Child & Adolescent |
Taxonomy Definition: |