Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | PSY 12514 | CA |
N | 103TC0700X | Clinical Psychologist | PSY 12514 | CA |
Y | 103G00000X | Clinical Psychologist | PSY 12514 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY 12514 | CA |
N | 103TR0400X | Rehabilitation Psychologist | PSY 12514 | CA |
NPI | 1689694820 |
---|---|
Provider Name | Dr. Karen M. Salter-Moss |
First Address | Claremont, CA 91711-4736 |
Second Address | Claremont, CA 91711-4736 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 03/08/2010 |