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General NPI Number Information
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NPI Number | 1598811705
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Entity Type | Individual
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Provider Name | SETH KNOEPLER PH.D.
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Gender | Male
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Dates
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Enumeration Date | 01/28/2007
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Last Update Date | 07/06/2012
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Provider Practice Location Address
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Address Line | 415 CAMBRIDGE AVE SUITE 15
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City | PALO ALTO
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State | CA
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Zip | 94306-1600
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Country | US
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Telephone | 650-787-2111
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1481
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City | FELTON
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State | CA
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Zip | 95018-1481
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Country | US
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Telephone | 650-787-2111
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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 | PSY14235
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCS14392
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License Number State | CA
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