Individual
DR. JOHN LEE POWELL III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
5701 LONETREE BLVD, STE. 216, ROCKLIN, CA 95765-3772
(916) 342-4077
Mailing address
5701 LONETREE BLVD, STE. 216, ROCKLIN, CA 95765-3772
(916) 342-4077
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
23682
CA
103TC0700X
Clinical Psychologist
23682
CA
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
23682
CA
103TF0000X
Family Psychologist
23682
CA
103TM1800X
Intellectual & Developmental Disabilities Psychologist
23682
CA
Other
Enumeration date
10/03/2006
Last updated
08/28/2014
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