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General NPI Number Information
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NPI Number | 1225187644
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Entity Type | Individual
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Provider Name | ERIC A EGLI PHD
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Gender | Male
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 08/02/2017
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Provider Practice Location Address
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Address Line | 1001 RIVERSIDE AVE
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City | ROSEVILLE
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State | CA
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Zip | 95678-5134
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Country | US
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Telephone | 918-746-4671
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Fax |
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Provider Business Mailing Address
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Address Line | 128 EAST STREET
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City | AUBURN
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State | CA
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Zip | 95603
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Country | US
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Telephone | 530-492-4995
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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 | 103TH0100X
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Taxonomy Name | Health Service Psychologist
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License Number | PSY 17315
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License Number State | CA
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