Owens Valley Wellness
Psychologist, Clinical in Bishop, CA. Organization (NPI-2).
NPI number1295193720
StatusActive
Last updated in NPPESJan 28, 2016
Details
- NPI
- 1295193720
- Entity type
- Organization (NPI-2)
- Legal business name
- Owens Valley Wellness
- Organization subpart
- No
- Enumeration date
- Jan 28, 2016
- Last updated
- Jan 28, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | PSY27059 | CA | Yes |
Practice location
686 W Line StBishop, CA 93514-3315
Phone 760-920-6210
Mailing address
686 W Line StBishop, CA 93514-3315
Phone 760-920-6210
Authorized official
Jacob Eide
Clinical Psychologist/Owner
7609206210
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