Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY24350 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY24350 | CA |
NPI | 1013071497 |
---|---|
Provider Name | Dr. Jennifer Kugel Fritz |
First Address | Alpine, CA 91901-1102 |
Second Address | Alpine, CA 91901-1102 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2006 |
Last Update Date | 19/10/2013 |