Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PSY12013 | CA |
Y | 103T00000X | Psychologist | PSY12013 | CA |
NPI | 1003058256 |
---|---|
Provider Name | Margaret Mary Decker |
First Address | Newport Beach, CA 92660-2432 |
Second Address | Newport Beach, CA 92660-2432 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2009 |
Last Update Date | 25/06/2013 |