Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
Y | 102L00000X | Psychologist | 32910 | CA |
Y | 103T00000X | Psychologist | 32910 | CA |
NPI | 1003334509 |
---|---|
Provider Name | Dr. Emily Eloise Livermore |
First Address | Palo Alto, CA 94304-1419 |
Second Address | Palo Alto, CA 94304-1419 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2017 |
Last Update Date | 02/11/2021 |