Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | ||
N | 103T00000X | Psychologist | ||
N | 103TC1900X | Counseling Psychologist | CA | |
Y | 103TR0400X | Rehabilitation Psychologist | CA |
NPI | 1134566797 |
---|---|
Provider Name | Dr. Elizabeth Anne Mcdade-Montez |
First Address | Santa Cruz, CA 95060-1976 |
Second Address | Santa Cruz, CA 95060-1976 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2013 |
Last Update Date | 22/11/2013 |