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Individual
DR. KRISTEN VIRGINIA EDDY
Active
Individual
DR. KRISTEN VIRGINIA EDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD, MACL
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY29193
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CB290129
MEDICARE ID
CA
Enumeration date
10/03/2016
Last updated
05/31/2018
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