Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PSY5497 | CA |
Y | 103T00000X | Psychologist | PSY5497 | CA |
NPI | 1013046143 |
---|---|
Provider Name | Dr. Miriam E. Erb |
First Address | San Diego, CA 92103-1840 |
Second Address | San Diego, CA 92103-1840 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2007 |
Last Update Date | 07/04/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
PL54970 | (05) | CA |
PSY5497 | (02) | CA |