Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 8060 | CA |
Y | 103TC0700X | Clinical Psychologist | 8060 | CA |
NPI | 1013063767 |
---|---|
Provider Name | Victoria Pickering |
First Address | Jackson, CA 95642-2160 |
Second Address | Jackson, CA 95642-2160 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2007 |
Last Update Date | 27/09/2013 |