Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PSY22906 | CA |
Y | 103T00000X | Psychologist | PSY22906 | CA |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | PSY22906 | CA |
N | 103TB0200X | Cognitive & Behavioral Psychologist | PSY22906 | CA |
N | 103G00000X | Clinical Psychologist | PSY22906 | CA |
N | 103TC0700X | Clinical Psychologist | PSY22906 | CA |
N | 103TC1900X | Counseling Psychologist | PSY22906 | CA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | PSY22906 | CA |
N | 103TF0200X | Forensic Psychologist | PSY22906 | CA |
N | 103TH0004X | Health Psychologist | PSY22906 | CA |
N | 103TH0100X | Health Service | PSY22906 | CA |
N | 103TP2701X | Group Psychotherapist | PSY22906 | CA |
NPI | 1134142292 |
---|---|
Provider Name | Bradley Robert Meier |
First Address | South Pasadena, CA 91030-3754 |
Second Address | Los Angeles, CA 90071-2004 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 11/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
S97453 | (02) | PA |