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General NPI Number Information
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NPI Number | 1114059664
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Entity Type | Individual
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Provider Name | CARRIE D. THALER PH.D.
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Gender | Female
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Dates
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Enumeration Date | 03/11/2007
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Last Update Date | 07/14/2007
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Provider Practice Location Address
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Address Line | 902 CURTIS ST
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City | ALBANY
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State | CA
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Zip | 94706-2108
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Country | US
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Telephone | 510-466-5691
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Fax |
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Provider Business Mailing Address
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Address Line | 902 CURTIS ST
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City | ALBANY
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State | CA
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Zip | 94706-2108
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Country | US
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Telephone | 510-466-5691
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | PSY13820
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY13820
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 103TF0200X
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Taxonomy Name | Forensic Psychologist
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License Number | PSY13820
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 103TP0814X
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Taxonomy Name | Psychoanalysis Psychologist
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License Number | PSY13820
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY13820
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License Number State | CA
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Taxonomy #6
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Taxonomy Code | 103TR0400X
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Taxonomy Name | Rehabilitation Psychologist
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License Number | PSY13820
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License Number State | CA
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