Individual
MARIA JOSE PRIETO DE ESTEBECORENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH,D.
Contact information
Practice address
2154 4TH ST, SAN RAFAEL, CA 94901-2694
(415) 457-3451
(415) 457-3819
Mailing address
2154 4TH ST, SAN RAFAEL, CA 94901-2694
(415) 457-3451
(415) 457-3819
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PSY22819
CA
103T00000X
Psychologist
PSY22819
CA
Other
Enumeration date
08/03/2009
Last updated
03/14/2011
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