Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY23124 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY23124 | CA |
NPI | 1013056258 |
---|---|
Provider Name | Miss Tania Isabel Texidor |
First Address | Redwood City, CA 94063-2612 |
Second Address | Redwood City, CA 94063-2612 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2007 |
Last Update Date | 03/01/2022 |