Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY15941 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY15941 | CA |
NPI | 1003358102 |
---|---|
Provider Name | Susan Spinrad |
First Address | Stanford, CA 94309-8823 |
Second Address | Palo Alto, CA 94306-1153 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2016 |
Last Update Date | 07/11/2016 |