Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | PSY9438 | CA |
NPI | 1003828518 |
---|---|
Provider Name | Smadar Aviv |
First Address | Fresno, CA 93720-3375 |
Second Address | Fresno, CA 93720-3375 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2006 |
Last Update Date | 08/07/2007 |