Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY16586 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY16586 | CA |
N | 103G00000X | Clinical Psychologist | PSY16586 | CA |
N | 103TC0700X | Clinical Psychologist | PSY16586 | CA |
NPI | 1013057181 |
---|---|
Provider Name | Dr. Brenda A. Austin |
First Address | San Francisco, CA 94116-1411 |
Second Address | San Francisco, CA 94116-1411 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2007 |
Last Update Date | 18/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P42072 | (02) | CA |
PSY165860 | (05) | CA |