Individual
CALLISTA FRYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
5905 LAKE EARL DR, CRESCENT CITY, CA 95532-5353
(707) 465-1000
Mailing address
5905 LAKE EARL DR, CRESCENT CITY, CA 95532-0001
(805) 704-7617
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY29061
CA
103TC0700X
Clinical Psychologist
T-LP 2099
KS
390200000X
Student in an Organized Health Care Education/Training Program
B7715996
CA
Other
Enumeration date
09/18/2007
Last updated
11/15/2023
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