Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PSY 9077 | CA |
Y | 103T00000X | Psychologist | PSY 9077 | CA |
NPI | 1013139765 |
---|---|
Provider Name | Dr. Royce B. Garvin |
First Address | Redwood City, CA 94061-1132 |
Second Address | Redwood City, CA 94061-3402 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2007 |
Last Update Date | 08/07/2007 |