Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | PSY23795 | CA |
N | 103G00000X | Clinical Psychologist | P0000002664 | TN |
N | 103TC0700X | Clinical Psychologist | P0000002664 | TN |
NPI | 1205017688 |
---|---|
Provider Name | Arnold S Presley |
First Address | Santee, CA 92071-4294 |
Second Address | Santee, CA 92071-4294 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2007 |
Last Update Date | 21/03/2018 |