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NPI 1619162310

NPI 1619162310 : ARIELLA VERED POPPLE PSYD : ALBANY, CA

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General NPI Number Information
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    NPI Number           |    1619162310
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    Entity Type          |    Individual 
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    Provider Name        |    ARIELLA VERED POPPLE PSYD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/06/2007
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    Last Update Date     |    12/20/2018
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Provider Practice Location Address
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    Address Line         |    1035 SAN PABLO AVE STE 9 
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    City                 |    ALBANY
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    State                |    CA
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    Zip                  |    94706-2277
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    Country              |    US
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    Telephone            |    510-409-5222
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    913 ADAMS ST APT C 
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    City                 |    ALBANY
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    State                |    CA
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    Zip                  |    94706-2057
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    Country              |    US
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    Telephone            |    
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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        |    103TC0700X
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    Taxonomy Name        |    Clinical Psychologist
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    License Number       |    27531
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    License Number State |    CA
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