Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY18156 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY18156 | CA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | PSY18156 | CA |
NPI | 1124318613 |
---|---|
Provider Name | Dr. Leeann Borton Harvey |
First Address | Walnut Creek, CA 94596-5340 |
Second Address | Walnut Creek, CA 94596-5340 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2011 |
Last Update Date | 18/04/2011 |