Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | PSY14006 | CA |
NPI | 1093740466 |
---|---|
Provider Name | Dr. Susan Tobin |
First Address | Chico, CA 95928-5556 |
Second Address | Chico, CA 95928-5556 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 08/07/2007 |