Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY12805 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY12805 | CA |
NPI | 1013051853 |
---|---|
Provider Name | Dr. Estela Reyes Garcia |
First Address | San Francisco, CA 94110-3917 |
Second Address | San Francisco, CA 94110-3917 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2007 |
Last Update Date | 08/07/2007 |