Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | PSY13760 | CA |
N | 103T00000X | Psychologist | PSY13760 | CA |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | PSY13760 | CA |
N | 103TA0700X | Adult Development & Aging Psychologist | PSY13760 | CA |
Y | 103G00000X | Clinical Psychologist | PSY13760 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY13760 | CA |
N | 103G00000X | Clinical Psychologist | PY60626989 | WA |
N | 103TC0700X | Clinical Psychologist | PY60626989 | WA |
N | 103TE1100X | Exercise & Sports Psychologist | PSY13760 | CA |
N | 103TF0200X | Forensic Psychologist | PSY13760 | CA |
N | 103TH0004X | Health Psychologist | PSY13760 | CA |
N | 103TP2701X | Group Psychotherapist | PSY13760 | CA |
NPI | 1750731246 |
---|---|
Provider Name | Dr. Bartlett Jeff Jarvis |
First Address | Chula Vista, CA 91910-7768 |
Second Address | Chula Vista, CA 91910-7768 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2016 |
Last Update Date | 15/06/2016 |