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Individual
DR. MARK H MICHAELS
Active
Individual
DR. MARK H MICHAELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
PSY14795
CA
103TC0700X
Clinical Psychologist
Primary
PSY14795
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PSY14795
LICENSE #
CA
Enumeration date
02/19/2008
Last updated
01/05/2012
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