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Organization
NORTH BAY NEUROPSYCHOLOGY A PSYCHOLOGY CORPORATION
Active
Organization
NORTH BAY NEUROPSYCHOLOGY A PSYCHOLOGY CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELLEN O'TOOLE PH.D. (PRESIDENT)
(707) 829-5057
Entity
Organization
Contact information
Practice address
1221 FARMERS LN STE C, SANTA ROSA, CA 95405-6712
(707) 829-5057
(707) 829-5084
Mailing address
1221 FARMERS LN STE C, SANTA ROSA, CA 95405-6712
(707) 829-5057
(707) 829-5084
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
22201
CA
103TC0700X
Clinical Psychologist
22201
CA
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
22201
CA
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
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Other
Enumeration date
02/25/2015
Last updated
07/17/2024
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