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General NPI Number Information
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NPI Number | 1568599868
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Entity Type | Individual
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Provider Name | GERALD PIAGET PHD
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Gender | Male
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 08/07/2007
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Provider Practice Location Address
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Address Line | 4370 ALPINE RD STE 209
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City | PORTOLA VALLEY
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State | CA
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Zip | 94028-7953
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Country | US
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Telephone | 650-851-8411
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Fax |
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Provider Business Mailing Address
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Address Line | 430 MINOCA RD
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City | PORTOLA VALLEY
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State | CA
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Zip | 94028-7767
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Country | US
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Telephone | 650-279-8336
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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 | PSY3819
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License Number State | CA
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