Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | PSY21941 | CA |
N | 103T00000X | Psychologist | PSY21941 | CA |
N | 103TA0700X | Adult Development & Aging Psychologist | PSY21941 | CA |
N | 103TB0200X | Cognitive & Behavioral Psychologist | PSY21941 | CA |
Y | 103G00000X | Clinical Psychologist | PSY21941 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY21941 | CA |
N | 103TC1900X | Counseling Psychologist | PSY21941 | CA |
NPI | 1508197195 |
---|---|
Provider Name | Dr. Jo Ellen Elizabeth Eng |
First Address | Santa Barbara, CA 93108-2737 |
Second Address | Santa Barbara, CA 93108-2737 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2010 |
Last Update Date | 20/01/2010 |