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General NPI Number Information
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NPI Number | 1205040961
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Entity Type | Individual
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Provider Name | BRUCE W MEYER PH.D.
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Gender | Male
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 02/19/2025
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Provider Practice Location Address
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Address Line | 115A CORAL ST
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City | SANTA CRUZ
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State | CA
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Zip | 95060-2131
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Country | US
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Telephone | 831-454-2080
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Fax |
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Provider Business Mailing Address
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Address Line | 1080 EMELINE AVE HOMELESS PERSONS HEALTH PROJECT
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City | SANTA CRUZ
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State | CA
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Zip | 95060-1966
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Country | US
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Telephone | 831-454-5182
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | PSY 17557
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License Number State | CA
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