Healthcare Provider Details

I. General information

NPI: 1538308705
Provider Name (Legal Business Name): ELIZABETH BOYER PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/11/2009
Last Update Date: 02/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

228 B ST
DAVIS CA
95616-4505
US

IV. Provider business mailing address

390 RICK HEINRICH CIR
SACRAMENTO CA
95835-1747
US

V. Phone/Fax

Practice location:
  • Phone: 530-321-4270
  • Fax:
Mailing address:
  • Phone: 530-321-4270
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number22276
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: