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General NPI Number Information
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NPI Number | 1942363122
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Entity Type | Individual
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Provider Name | SUZANNE GAYNOR SLOMAN PHD
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Gender | Female
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 20081 LAKE CHABOT BLVD
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City | CASTRO VALLEY
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State | CA
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Zip | 94546
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Country | US
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Telephone | 510-881-2026
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Fax | 510-690-1344
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Provider Business Mailing Address
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Address Line | 559 COLUSA AVE
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City | BERKELY
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State | CA
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Zip | 94707-1530
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Country | US
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Telephone | 510-881-2026
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Fax | 510-690-1344
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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 | PSY5422
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License Number State | CA
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