Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | PSY 17985 | CA |
N | 103T00000X | Psychologist | PSY 17985 | CA |
N | 103G00000X | Clinical Psychologist | PSY 17985 | CA |
N | 103TC0700X | Clinical Psychologist | PSY 17985 | CA |
NPI | 1013133099 |
---|---|
Provider Name | Dr. Susan D Waldman |
First Address | San Francisco, CA 94116-1424 |
Second Address | San Francisco, CA 94115-2532 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2007 |
Last Update Date | 08/07/2007 |