Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PSY11564 | CA |
Y | 103T00000X | Psychologist | PSY11564 | CA |
N | 103TA0700X | Adult Development & Aging Psychologist | PSY11564 | CA |
N | 103TB0200X | Cognitive & Behavioral Psychologist | PSY11564 | CA |
N | 103G00000X | Clinical Psychologist | PSY11564 | CA |
N | 103TC0700X | Clinical Psychologist | PSY11564 | CA |
N | 103TC1900X | Counseling Psychologist | PSY11564 | CA |
N | 103TF0000X | Family Psychologist | PSY11564 | CA |
N | 103TH0004X | Health Psychologist | PSY11564 | CA |
N | 103TH0100X | Health Service | PSY11564 | CA |
NPI | 1457564494 |
---|---|
Provider Name | Dr. Carolyn S. Stroebe |
First Address | San Rafael, CA 94903-2544 |
Second Address | San Rafael, CA 94903 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2007 |
Last Update Date | 20/07/2018 |