Individual
DR. CHARLES E ODENTHAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
285 HARVARD DR, LARKSPUR, CA 94939-1130
(415) 924-7021
Mailing address
285 HARVARD DR, LARKSPUR, CA 94939-1130
(415) 924-7021
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
13011
CA
Other
Enumeration date
04/26/2007
Last updated
07/08/2007
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