Mark David Ettensohn in Sacramento - Psychologist
Mark David Ettensohn - NPI 1417147703
Mark David Ettensohn is a Psychologist in Sacramento, California. Mark David Ettensohn practices all healthcare services and medical treatments related to Psychologist. The NPI Number for Mark David Ettensohn is 1417147703. The last update date is 2013-01-03.
Mark David Ettensohn's current location address is 835 University Ave, Sacramento, California. You can contact this provider via phone number 9165383019. The mailing address for Mark David Ettensohn is 835 University Ave, Sacramento, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mark David Ettensohn |
|---|---|
| Address | 835 University Ave, Sacramento, California |
| Phone Number | 9165383019 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | PSY.D. |
NPI Number Detail
| NPI Number | 1417147703 |
|---|---|
| Provider Enumeration Date | 2007-08-01 |
| Last Updated Date | 2013-01-03 |
Provider Mailing Address Detail
| Address | 835 University Ave |
|---|---|
| City | Sacramento |
| State | California (CA) |
| Post Code | 958256724 |
| Phone Number | 9165383019 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Psychologist |
|---|---|
| Taxonomy | 103T00000X |
| Licence No | PSY 25461 |
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Definition: A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and proce |
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What is the unique 10-digit identifier code assigned to Mark David Ettensohn by the Centers for Medicare & Medicaid Services?
The Mark David Ettensohn has been issued the NPI (National Provider Identifier) 1417147703 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Where is the Mark David Ettensohn located?
The Mark David Ettensohn is located at 835 University Ave, Sacramento, CA 958256724.
What is Mark David Ettensohn's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Mark David Ettensohn is Psychologist, and the taxonomy classification code that categorizes this area of expertise is 103T00000X.
On what date was the 1417147703 assigned to Mark David Ettensohn?
The Mark David Ettensohn was issued its 1417147703 on 2007-08-01, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details related to Mark David Ettensohn most recently updated or revised?
The information pertaining to Mark David Ettensohn, including its address, specialty, and other relevant details, was last updated or revised on 2013-01-03.