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General NPI Number Information
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NPI Number | 1700932688
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Entity Type | Individual
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Provider Name | GARY NORMAN SLUTZKY PH.D.
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Gender | Male
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 12/30/2021
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Provider Practice Location Address
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Address Line | 1660 E ROSEVILLE PKWY
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City | ROSEVILLE
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State | CA
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Zip | 95661-3988
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Country | US
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Telephone | 916-878-4003
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Fax | 916-878-4039
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Provider Business Mailing Address
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Address Line | 1660 E ROSEVILLE PKWY
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City | ROSEVILLE
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State | CA
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Zip | 95661-3988
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Country | US
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Telephone | 916-878-4003
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Fax | 916-878-4039
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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 | PSY4962
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License Number State | CA
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