Individual
KIRSTEN MARCEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
290 I O O F AVE, GILROY, CA 95020-5204
(408) 846-2100
Mailing address
290 I O O F AVE, GILROY, CA 95020-5204
(408) 846-2100
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PSY 20465
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3587
UNICARE NUMBER
CA
Enumeration date
11/29/2006
Last updated
07/08/2007
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