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General NPI Number Information
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NPI Number | 1346657582
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Entity Type | Organization
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Legal Business Name | DR DEARMOND
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Dates
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Enumeration Date | 07/21/2014
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Last Update Date | 07/21/2014
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Provider Practice Location Address
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Address Line | 13120 POMO LN
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City | MENDOCINO
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State | CA
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Zip | 95460-9602
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Country | US
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Telephone | 707-937-2590
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Fax |
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Provider Business Mailing Address
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Address Line | 13120 POMO LANE
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City | MENDOCINO
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State | CA
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Zip | 95460
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Country | US
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Telephone | 707-937-2590
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. ISABELLE M DE ARMOND
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Credential | MD, PHD
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Telephone | 707-599-7626
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY25905
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License Number State | CA
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