Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | PSY23261 | CA |
Y | 103G00000X | Clinical Psychologist | 018460-1 | NY |
Y | 103TC0700X | Clinical Psychologist | 018460-1 | NY |
NPI | 1366752685 |
---|---|
Provider Name | Lawrence M. Ferber |
First Address | Redwood City, CA 94061-2769 |
Second Address | Belmont, CA 94002-4018 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2010 |
Last Update Date | 22/09/2014 |