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Individual
MR. WALTER BROWN
Active
Individual
MR. WALTER BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY19358
CA
103TC0700X
Clinical Psychologist
PSY 19358
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FC392A
MEDICARE PTAN
CA
05
—
PSY 193580
—
CA
Enumeration date
09/13/2006
Last updated
06/13/2025
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