Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | ||
Y | 103T00000X | Psychologist |
NPI | 1013150176 |
---|---|
Provider Name | Eva K Pang |
First Address | San Francisco, CA 94132-1222 |
Second Address | San Mateo, CA 94401-4051 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2009 |
Last Update Date | 06/05/2014 |