Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | PSY15581 | CA |
N | 103G00000X | Clinical Psychologist | PSY15581 | CA |
N | 103TC0700X | Clinical Psychologist | PSY15581 | CA |
NPI | 1568408284 |
---|---|
Provider Name | Dr. Eric Geffner |
First Address | Los Angeles, CA 90024-4932 |
Second Address | Los Angeles, CA 90024-4941 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2006 |
Last Update Date | 08/07/2007 |