Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | ||
Y | 103TH0100X | Health Service |
NPI | 1154584894 |
---|---|
Provider Name | Dr. Eric John Niemeyer |
First Address | Vacaville, CA 95688 |
Second Address | Vacaville, CA 95688 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2008 |
Last Update Date | 09/09/2015 |