Organization
SONOMA MEMORY CENTER COMPREHENSIVE PSYCHOLOGY SERVICES PROFESSIONAL CO
Active
Organization
SONOMA MEMORY CENTER COMPREHENSIVE PSYCHOLOGY SERVICES PROFESSIONAL CO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDGAR O ANGELONE PHD (PRESIDENT)
(707) 546-3300
Entity
Organization
Contact information
Practice address
1111 SONOMA AVE, STE 322, SANTA ROSA, CA 95405-4819
(707) 546-3300
(415) 457-3819
Mailing address
1111 SONOMA AVE, STE 322, SANTA ROSA, CA 95405-4819
(707) 546-3300
(415) 457-3819
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PSY13957
CA
Other
Enumeration date
07/29/2010
Last updated
03/16/2011
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