Doctor Name: | LIZA SIEGEL |
NPI Number: | 1528365640 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 17246 |
Business Practice Address: | 1325 Mar West St Apt 6 Tiburon, CA - 949201845 |
Business Phone Number: | 8054033839 |
Business Fax Number: | |
Mailing Address: | 1325 Mar West St Apt 6, TIBURON |
State: | CA |
Postal Code: | 949201845 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 02/25/2011 |
NPI Last Update Date: | 02/25/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 17246 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |