Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 24911 | CA |
Y | 103T00000X | Psychologist | 24911 | CA |
NPI | 1003227455 |
---|---|
Provider Name | Mr. Benjamin Joseph Levin |
First Address | Napa, CA 94558-6293 |
Second Address | Napa, CA 94558-6293 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2014 |
Last Update Date | 19/05/2014 |