Ellen Marie Theobald in Riverside - Clinical
Ellen Marie Theobald - NPI 1962576223
Ellen Marie Theobald is a Clinical in Riverside, California. Ellen Marie Theobald practices all healthcare services and medical treatments related to Clinical. The NPI Number for Ellen Marie Theobald is 1962576223. The last update date is 2007-07-08.
Ellen Marie Theobald's current location address is 5307 Stonewood Dr, Riverside, California. You can contact this provider via phone number 9516832684 and fax number 9516832766. The mailing address for Ellen Marie Theobald is 5307 Stonewood Dr, Riverside, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Ellen Marie Theobald |
|---|---|
| Address | 5307 Stonewood Dr, Riverside, California |
| Phone Number | 9516832684 |
| Fax Number | 9516832766 |
| Sole Proprietor | N |
| Credentials | PHD |
NPI Number Detail
| NPI Number | 1962576223 |
|---|---|
| Provider Enumeration Date | 2006-11-20 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 5307 Stonewood Dr |
|---|---|
| City | Riverside |
| State | California (CA) |
| Post Code | 92506 |
| Phone Number | 9516832684 |
| Fax Number | 9516832766 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | PSY9953 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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What is the unique 10-digit identifier code assigned to Ellen Marie Theobald by the Centers for Medicare & Medicaid Services?
The Ellen Marie Theobald has been issued the NPI (National Provider Identifier) 1962576223 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you please provide the complete physical location address of Ellen Marie Theobald?
The Ellen Marie Theobald is physically situated at 5307 Stonewood Dr, in the city of Riverside, state of CA, with the postal code 92506.
What is Ellen Marie Theobald's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Ellen Marie Theobald is Clinical, and the corresponding taxonomy classification code for this specialized field is 103Tc0700X.
On what date did Ellen Marie Theobald receive its 1962576223 assignment from the Centers for Medicare & Medicaid Services?
The Ellen Marie Theobald was assigned its 1962576223 on 2006-11-20, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the information regarding Ellen Marie Theobald most recently updated?
The details pertaining to the Ellen Marie Theobald, including its address, specialty, and other relevant information, were last refreshed on 2007-07-08.
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