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General NPI Number Information
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NPI Number | 1427303999
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Entity Type | Individual
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Provider Name | ELIZABETH L REICHERT PHD
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Gender | Female
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Dates
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Enumeration Date | 07/19/2012
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Last Update Date | 04/29/2024
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Provider Practice Location Address
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Address Line | 725 WELCH RD
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City | PALO ALTO
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State | CA
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Zip | 94304-1601
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Country | US
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Telephone | 650-497-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 401 QUARRY ROAD STANFORD MEDICAL CENTER, DEPT PSYCHIATRY
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City | STANFORD
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State | CA
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Zip | 94305-5719
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Country | US
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Telephone | 650-723-7704
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY26513
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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 | PSY26513
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | PSY26513
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License Number State | CA
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