Doctor Name: | JUDITH L CARL |
NPI Number: | 1992883128 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PHD |
License Number: | PSY10304 |
Business Practice Address: | 300 Tejon Place Suite 5 Palos Verdes Estates, CA - 902741204 |
Business Phone Number: | 3103771198 |
Business Fax Number: | 3105444620 |
Mailing Address: | 300 Tejon Place, Suite 5 PALOS VERDES ESTATES |
State: | CA |
Postal Code: | 902741204 |
Phone Number: | 3103771198 |
Fax Number: | 3105444620 |
NPI Enumeration Date: | 11/02/2006 |
NPI Last Update Date: | 10/24/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PSY10304 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |