Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY22895 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY22895 | CA |
N | 102L00000X | Psychologist | PY7199 | FL |
N | 103T00000X | Psychologist | PY7199 | FL |
NPI | 1003838095 |
---|---|
Provider Name | Jeffrey C Wertheimer |
First Address | South Pasadena, CA 91030-2630 |
Second Address | South Pasadena, CA 91030-2630 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 17/08/2009 |