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General NPI Number Information
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NPI Number | 1811070865
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Entity Type | Individual
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Provider Name | CAROLYN JOANNE GREENE PH.D.
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Gender | Female
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 08/14/2009
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Provider Practice Location Address
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Address Line | 795 WILLOW RD # PTSD-334 NATIONAL CENTER FOR PTSD
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City | MENLO PARK
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State | CA
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Zip | 94025-2539
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Country | US
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Telephone | 650-493-5000
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Fax | 650-617-2701
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Provider Business Mailing Address
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Address Line | 795 WILLOW RD # PTSD-334 NATIONAL CENTER FOR PTSD
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City | MENLO PARK
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State | CA
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Zip | 94025-2539
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Country | US
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Telephone | 650-493-5000
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Fax | 650-617-2701
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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 | 969
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License Number State | HI
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