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Individual
PAMELA SUE PINE
Active
Individual
PAMELA SUE PINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
PSY16970
CA
103T00000X
Psychologist
PSY6970
CA
103TA0400X
Addiction (Substance Use Disorder) Psychologist
PSY16970
CA
103TC0700X
Clinical Psychologist
Primary
PSY16970
CA
103TF0200X
Forensic Psychologist
PSY16970
CA
103TP0814X
Psychoanalysis Psychologist
PSY16970
CA
103TP2701X
Group Psychotherapy Psychologist
PSY16970
CA
106H00000X
Marriage & Family Therapist
MFT17040
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
160373
VALUEOPTIONS
—
01
—
202957000
DEPT OF LABOR
CA
01
—
710955581
BLUE CROSS
CA
Enumeration date
11/01/2006
Last updated
12/02/2011
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