Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY25425 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY25425 | CA |
NPI | 1003048968 |
---|---|
Provider Name | Dr. Matthew Metzger |
First Address | Los Gatos, CA 95032-5407 |
Second Address | Los Gatos, CA 95032-5407 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2009 |
Last Update Date | 15/07/2014 |