Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 17937 | CA |
NPI | 1023025194 |
---|---|
Provider Name | Dr. Frederick Adams Stich III |
First Address | Redding, CA 96002-0159 |
Second Address | Redding, CA 96002-0159 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2006 |
Last Update Date | 08/07/2007 |