Organization
CAROL VISSER, PHD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CAROL J VISSER PHD (PRESIDENT)
(530) 889-8480
Entity
Organization
Contact information
Practice address
122 EAST ST, AUBURN, CA 95603-5119
(530) 889-8480
Mailing address
122 EAST ST, AUBURN, CA 95603-5119
(530) 889-8480
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
PSY8619
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PSY8619
CLINICAL PSYCH LIC
CA
Enumeration date
12/18/2007
Last updated
12/18/2007
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