Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | ||
Y | 102L00000X | Psychologist | PSY26086 | CA |
Y | 103T00000X | Psychologist | PSY26086 | CA |
NPI | 1003000852 |
---|---|
Provider Name | Triona Coyle |
First Address | Oakland, CA 94661-0088 |
Second Address | San Francisco, CA 94102-3020 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/09/2007 |
Last Update Date | 19/12/2019 |