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General NPI Number Information
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NPI Number | 1942635859
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Entity Type | Organization
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Legal Business Name | EDWARD J. HYMAN, PH.D. A PROFESSIONAL PSYCHOLOGICAL CORPORATION
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Dates
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Enumeration Date | 09/10/2013
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Last Update Date | 09/10/2013
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Provider Practice Location Address
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Address Line | 39 SEACAPE DR
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City | MUIR BEACH
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State | CA
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Zip | 94965-9760
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Country | US
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Telephone | 415-388-4479
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Fax | 415-388-5009
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Provider Business Mailing Address
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Address Line | 39 SEACAPE DR
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City | MUIR BEACH
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State | CA
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Zip | 94965-9760
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Country | US
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Telephone | 415-388-4479
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Fax | 415-388-5009
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EDWARD J HYMAN
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Credential | PH.D.
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Telephone | 415-388-4479
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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 | PSY5684
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License Number State | CA
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