Individual
VANESA D GOERTZEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
205 SOUTH ST, FORT BRAGG, CA 95437-5540
(707) 964-1251
(707) 961-2722
Mailing address
205 SOUTH ST, FORT BRAGG, CA 95437-5540
(707) 964-1251
(707) 961-2722
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
PSY17451
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FHC03967F
—
CA
Enumeration date
03/20/2007
Last updated
07/08/2007
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