=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922283795
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROBERT OWEN BOYD PHD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/29/2007
-----------------------------------------------------
Last Update Date | 12/29/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2800 PLEASANT HILL ROAD SUITE 110
-----------------------------------------------------
City | PLEASANT HILL
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94523
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 925-330-6932
-----------------------------------------------------
Fax | 925-609-8723
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2800 PLEASANT HILL ROAD SUITE 110
-----------------------------------------------------
City | PLEASANT HILL
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94523
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 925-330-6932
-----------------------------------------------------
Fax | 925-609-8723
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103T00000X
-----------------------------------------------------
Taxonomy Name | Psychologist
-----------------------------------------------------
License Number | PSY8158
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------