Individual
CHARLES P BRODERICK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
10333 EL CAMINO REAL, ATASCADERO, CA 93423-7001
(805) 468-2000
(805) 466-6011
Mailing address
1600 9TH ST, ROOM 205 MAILSTOP 2 3, SACRAMENTO, CA 95814-6414
(916) 654-2431
(916) 954-3186
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PSY17352
CA
Other
Enumeration date
05/17/2006
Last updated
07/08/2007
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