Individual
DR. EFRAIN SEGARRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
5557 CARYS BROOK LN, GLOUCESTER, VA 23061-2002
(757) 344-6747
(804) 695-1815
Mailing address
5557 CARYS BROOK LN, GLOUCESTER, VA 23061-2002
(757) 344-6747
(804) 695-1815
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
0810001283
VA
103T00000X
Psychologist
0810001283
VA
103TA0700X
Adult Development & Aging Psychologist
0810001283
VA
103TB0200X
Cognitive & Behavioral Psychologist
0810001283
VA
103TC0700X
Clinical Psychologist
Primary
0810001283
VA
103TC2200X
Clinical Child & Adolescent Psychologist
0810001283
VA
103TF0000X
Family Psychologist
0810001283
VA
103TF0200X
Forensic Psychologist
0810001283
VA
103TP2701X
Group Psychotherapy Psychologist
0810001283
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010164206
—
VA
05
—
010164851
—
VA
01
—
289120
ANTHEM BLUE CROSS
VA
Enumeration date
06/08/2005
Last updated
10/29/2008
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