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Individual
DR. MICHAEL GENE IDIART JR.
Active
Individual
DR. MICHAEL GENE IDIART JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY29830
CA
103TF0200X
Forensic Psychologist
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PSY29830
CALIFORNIA BOARD OF PSYCHOLOGY
CA
Enumeration date
03/16/2016
Last updated
01/12/2024
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