Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PSY11922 | CA |
Y | 103T00000X | Psychologist | PSY11922 | CA |
N | 103TF0200X | Forensic Psychologist | PSY11922 | CA |
N | 103TR0400X | Rehabilitation Psychologist | PSY11922 | CA |
NPI | 1093711749 |
---|---|
Provider Name | Abraham A Argun |
First Address | Riverside, CA 92501-1777 |
Second Address | Riverside, CA 92501-1777 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2005 |
Last Update Date | 10/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
W31899 | (02) | CA |