Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | PSY 15927 | CA |
N | 103TC0700X | Clinical Psychologist | PSY 15927 | CA |
Y | 103G00000X | Clinical Psychologist | PSY 15927 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY 15927 | CA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | PSY 15927 | CA |
N | 103TF0200X | Forensic Psychologist | PSY 15927 | CA |
N | 103TP0814X | Psychoanalysis | PSY 15927 | CA |
N | 103TS0200X | School Psychologist | PSY 15927 | CA |
NPI | 1073771317 |
---|---|
Provider Name | Dr. Charlotte Joanne Crawford |
First Address | Berkeley, CA 94702-2422 |
Second Address | Berkeley, CA 94705-1900 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2008 |
Last Update Date | 22/04/2016 |