Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY13744 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY13744 | CA |
N | 103TP2701X | Group Psychotherapist | PSY13744 | CA |
NPI | 1093865560 |
---|---|
Provider Name | Dr. Joan Crowley Mcwalters |
First Address | El Sobrante, CA 94803-3222 |
Second Address | El Sobrante, CA 94803-3222 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2007 |
Last Update Date | 25/10/2019 |