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General NPI Number Information
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NPI Number | 1568516797
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Entity Type | Individual
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Provider Name | MARIAN JOYCE PARKER PH.D.
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Gender | Female
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 17675 VAN BUREN BLVD STE A
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City | RIVERSIDE
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State | CA
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Zip | 92504-6076
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Country | US
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Telephone | 951-789-4410
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Fax | 951-789-9169
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Provider Business Mailing Address
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Address Line | 11231 PLATTE DR
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City | RIVERSIDE
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State | CA
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Zip | 92505-2243
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Country | US
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Telephone | 951-789-4410
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Fax | 951-789-9169
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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 | PSY 12724
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License Number State |
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