Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | ||
Y | 103G00000X | Clinical Psychologist | 27495 | CA |
Y | 103TC0700X | Clinical Psychologist | 27495 | CA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | ||
N | 103TF0000X | Family Psychologist | ||
N | 103TH0004X | Health Psychologist | ||
N | 103TP2701X | Group Psychotherapist |
NPI | 1467873778 |
---|---|
Provider Name | Mr. Ryan Roemer |
First Address | Irvine, CA 92618-0247 |
Second Address | Irvine, CA 92618-0247 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2014 |
Last Update Date | 22/09/2015 |