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Individual

DR. AUSTIN GOLLMER HURST

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D., M.A.

Contact information

Practice address
954 RISA RD, SUITE A, LAFAYETTE, CA 94549-3418
(925) 284-0691
(925) 283-2381
Mailing address
954 RISA RD, SUITE A, LAFAYETTE, CA 94549-3418
(925) 284-0691
(925) 283-2381

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY4909
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0PL49090
CA
Enumeration date
07/07/2006
Last updated
07/08/2007
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