Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 19274 | CA |
N | 103T00000X | Psychologist | 19274 | CA |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 19274 | CA |
N | 103TA0700X | Adult Development & Aging Psychologist | 19274 | CA |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 19274 | CA |
Y | 103G00000X | Clinical Psychologist | 19274 | CA |
Y | 103TC0700X | Clinical Psychologist | 19274 | CA |
N | 103TC1900X | Counseling Psychologist | 19274 | CA |
NPI | 1386887057 |
---|---|
Provider Name | Dr. Ronald W Pilato |
First Address | San Francisco, CA 94133-1303 |
Second Address | San Francisco, CA 94133-1303 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2009 |
Last Update Date | 10/04/2009 |