Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | PSY23372 | CA |
N | 103TC0700X | Clinical Psychologist | PSY23372 | CA |
N | 102L00000X | Psychologist | PSY23372 | CA |
N | 103T00000X | Psychologist | PSY23372 | CA |
N | 103TA0700X | Adult Development & Aging Psychologist | PSY23372 | CA |
Y | 103G00000X | Clinical Psychologist | PSY23372 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY23372 | CA |
N | 103TR0400X | Rehabilitation Psychologist | PSY23372 | CA |
NPI | 1376868307 |
---|---|
Provider Name | Alycia Shannon Zink |
First Address | Kaneohe, HI 96744-3036 |
Second Address | Tacoma, WA 98493-1522 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2010 |
Last Update Date | 27/01/2020 |