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Individual

GINA NEIKIRK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
33562 YUCAIPA BLVD # 4-133, YUCAIPA, CA 92399-2072
(909) 583-4040
(909) 217-3456
Mailing address
33562 YUCAIPA BLVD # 4-133, YUCAIPA, CA 92399-2072
(909) 583-4040
(909) 217-3456

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-10-7155
103T00000X
Psychologist
Primary
PSY18601
CA
103TC0700X
Clinical Psychologist
PSY18601
CA
103TM1800X
Intellectual & Developmental Disabilities Psychologist
PSY18601
CA

Other

Enumeration date
03/08/2012
Last updated
03/08/2012
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