Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSB31322 | CA |
Y | 103TC0700X | Clinical Psychologist | PSB31322 | CA |
NPI | 1013116094 |
---|---|
Provider Name | Dr. Tyler Devin Hinds |
First Address | Aliso Viejo, CA 92656-1548 |
Second Address | Santa Ana, CA 92701-3630 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2007 |
Last Update Date | 11/07/2007 |