Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY29765 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY29765 | CA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 022390 | NY |
N | 103TS0200X | School Psychologist |
NPI | 1124464581 |
---|---|
Provider Name | Emily Cyrano Patton |
First Address | Berkeley, CA 94710-2048 |
Second Address | Emeryville, CA 94608-1469 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2013 |
Last Update Date | 11/01/2022 |