Individual
DR. LOTHAR ENGELBERT MADER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
2130 PROFESSIONAL DR, SUITE 240, ROSEVILLE, CA 95661-3738
(916) 782-2100
(916) 624-0701
Mailing address
2130 PROFESSIONAL DR, SUITE 240, ROSEVILLE, CA 95661-3738
(916) 782-2100
(916) 624-0701
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY8474
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7366414
—
CA
Enumeration date
10/10/2005
Last updated
11/02/2007
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