Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | PSY6084 | CA |
N | 103TC0700X | Clinical Psychologist | PSY6084 | CA |
N | 102L00000X | Psychologist | PSY6084 | CA |
N | 103T00000X | Psychologist | PSY6084 | CA |
N | 103TA0700X | Adult Development & Aging Psychologist | PSY6084 | CA |
N | 103TB0200X | Cognitive & Behavioral Psychologist | PSY6084 | CA |
Y | 103G00000X | Clinical Psychologist | PSY6084 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY6084 | CA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | PSY6084 | CA |
N | 103TF0000X | Family Psychologist | PSY6084 | CA |
N | 103TF0200X | Forensic Psychologist | PSY6084 | CA |
N | 103TH0004X | Health Psychologist | PSY6084 | CA |
N | 103TH0100X | Health Service | PSY6084 | CA |
N | 103TM1800X | Intellectual & Developmental Disabilities | PSY6084 | CA |
N | 103TP2701X | Group Psychotherapist | PSY6084 | CA |
N | 103TR0400X | Rehabilitation Psychologist | PSY6084 | CA |
NPI | 1205046596 |
---|---|
Provider Name | Dr. Roger Alan Kleinman |
First Address | Huntington Beach, CA 92648-6002 |
Second Address | Huntington Beach, CA 92648-6002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 24/09/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
68-0493282 | BLUE CROSS (01) | CA |
VALUE OPTIONS | 176151 (01) | CA |