Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | PSY 18138 | CA |
N | 103TC0700X | Clinical Psychologist | PSY 18138 | CA |
N | 103G00000X | Clinical Psychologist | PSY18138 | CA |
N | 103TC0700X | Clinical Psychologist | PSY18138 | CA |
N | 103TR0400X | Rehabilitation Psychologist | PSY18138 | CA |
NPI | 1073684064 |
---|---|
Provider Name | Dr. Sabine Gysens |
First Address | San Francisco, CA 94131-3056 |
Second Address | San Francisco, CA 94114-1010 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
PSY18138 | STATE LICENSING NUMBER (01) | CA |