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General NPI Number Information
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NPI Number | 1477090488
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Entity Type | Organization
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Legal Business Name | CENTER FOR NEUROPSYCHOLOGY, A PSYCHOLOGICAL CORPORATION
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Dates
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Enumeration Date | 01/28/2017
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Last Update Date | 12/23/2020
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Provider Practice Location Address
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Address Line | 2628 VICTOR AVE STE B
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City | REDDING
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State | CA
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Zip | 96002-1454
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Country | US
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Telephone | 530-710-1070
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Fax |
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Provider Business Mailing Address
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Address Line | 2628 VICTOR AVE STE B
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City | REDDING
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State | CA
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Zip | 96002-1454
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Country | US
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Telephone | 530-710-1070
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TAMMY GRABRECK
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Credential | PHD
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Telephone | 530-710-1070
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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 | PSY26823
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License Number State | CA
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