Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TB0200X | Cognitive & Behavioral Psychologist | PSB34293 | CA |
Y | 103G00000X | Clinical Psychologist | PSB34293 | CA |
Y | 103TC0700X | Clinical Psychologist | PSB34293 | CA |
N | 103TC1900X | Counseling Psychologist | PSB34293 | CA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | PSB34293 | CA |
N | 103TF0000X | Family Psychologist | PSB34293 | CA |
N | 103TP2701X | Group Psychotherapist | PSB34293 | CA |
NPI | 1215235643 |
---|---|
Provider Name | Dr. Mirta Romero Frimtzis |
First Address | Palm Desert, CA 92260-2573 |
Second Address | Palm Desert, CA 92260-2573 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2011 |
Last Update Date | 09/03/2011 |