Organization Name: | HALLOWELL-WEST MEDICAL CENTER |
NPI Number: | 1972728921 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KENNETH A. SELZER (OWNER) |
Mailing Address: | 140 Marine View Ave Suite 110 Solana Beach |
State: | CA US |
Postal Code: | 920752133 |
Phone Number: | 8583504595 |
Fax Number: | 8583504596 |
NPI Enumeration Date: | 04/16/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103G00000X |
License Number: | PSY 17903 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Clinical Neuropsychologist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |