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General NPI Number Information
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NPI Number | 1891842597
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Entity Type | Organization
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Legal Business Name | ERROL D. SCHUBOT, PH.D., A PSYCHOLOGICAL CORPORATION
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 07/25/2018
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Provider Practice Location Address
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Address Line | 1745 SARATOGA AVE
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City | SAN JOSE
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State | CA
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Zip | 95129
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Country | US
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Telephone | 408-241-0198
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Fax |
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Provider Business Mailing Address
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Address Line | 1745 SARATOGA AVE
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City | SAN JOSE
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State | CA
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Zip | 95129-5201
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Country | US
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Telephone | 408-241-0198
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ERROL D. SCHUBOT
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Credential | PH.D.
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Telephone | 408-241-0198
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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 | PSY 003164
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License Number State | CA
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