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General NPI Number Information
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NPI Number | 1952492530
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Entity Type | Organization
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Legal Business Name | GREGORY IAN FIELDS, PH. D. PSYCHOLOGIST, INC.
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 12/11/2023
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Provider Practice Location Address
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Address Line | 2929 K ST STE 300
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City | SACRAMENTO
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State | CA
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Zip | 95816-5122
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Country | US
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Telephone | 916-425-3177
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Fax | 916-914-2073
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Provider Business Mailing Address
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Address Line | 2929 K ST STE 300
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City | SACRAMENTO
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State | CA
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Zip | 95816-5122
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Country | US
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Telephone | 916-425-3177
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Fax | 916-914-2073
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Authorized Official
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Title or Position | PRESIDENT
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Name | GREGORY IAN FIELDS
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Credential | PH.D.
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Telephone | 916-425-3177
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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 | PSY16113
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License Number State | CA
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