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General NPI Number Information
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NPI Number | 1780017392
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Entity Type | Organization
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Legal Business Name | STANLEY G EINHORN PHD
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Dates
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Enumeration Date | 08/19/2013
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Last Update Date | 08/19/2013
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Provider Practice Location Address
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Address Line | 6233 SOQUEL DR STE E
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City | APTOS
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State | CA
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Zip | 95003-3184
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Country | US
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Telephone | 831-359-5842
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Fax | 831-359-5842
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Provider Business Mailing Address
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Address Line | 231 TREVETHAN AVE
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City | SANTA CRUZ
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State | CA
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Zip | 95062-1201
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Country | US
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Telephone | 831-359-5842
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Fax | 831-359-5842
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | STANLEY G EINHORN
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Credential | PHD
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Telephone | 831-359-5842
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Psychologist
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License Number | PSY13906
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TA0700X
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Taxonomy Name | Adult Development & Aging Psychologist
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License Number | PSY13906
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 103TF0000X
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Taxonomy Name | Family Psychologist
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License Number | PSY13906
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY13906
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License Number State | CA
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