Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY 26981 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY 26981 | CA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | PSB34740 | CA |
NPI | 1023344926 |
---|---|
Provider Name | Simone Renee Beri |
First Address | Long Beach, CA 90810-1876 |
Second Address | Long Beach, CA 90810-1876 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2009 |
Last Update Date | 01/09/2016 |