Healthcare Provider Details

I. General information

NPI: 1538419940
Provider Name (Legal Business Name): CARA L. ARNDORFER PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2012
Last Update Date: 09/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

129 E ST SUITE C-3
DAVIS CA
95616-4658
US

IV. Provider business mailing address

129 E ST SUITE C-3
DAVIS CA
95616-4658
US

V. Phone/Fax

Practice location:
  • Phone: 530-302-5030
  • Fax:
Mailing address:
  • Phone: 530-302-5030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPSY24590
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: