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Individual

DR. JOHN THOMAS HAVEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
9093 ELK GROVE BLVD # 206, ELK GROVE, CA 95624-2047
(808) 284-7770
(888) 371-4292
Mailing address
4935 61ST ST, SACRAMENTO, CA 95820-5703
(808) 284-7770
(888) 371-4292

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
1124
HI
103T00000X
Psychologist
Primary
21388
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1124
PSYCHOLOGIST LICENSE
HI
01
21388
PSYCHOLOGIST LICENSE
CA
Enumeration date
06/28/2007
Last updated
09/16/2010
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