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General NPI Number Information
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NPI Number | 1962633263
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Entity Type | Individual
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Provider Name | ERIC NORMAN NADLER PH.D.
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Gender | Male
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Dates
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Enumeration Date | 08/04/2009
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Last Update Date | 03/28/2022
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Provider Practice Location Address
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Address Line | 99 MONTECILLO RD., MOB 2
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City | SAN RAFAEL
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State | CA
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Zip | 94903
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Country | US
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Telephone | 415-444-4860
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Fax | 415-444-4011
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Provider Business Mailing Address
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Address Line | 99 MONTECILLO ROAD, MOB2
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City | SAN RAFAEL
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State | CA
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Zip | 94903
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Country | US
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Telephone | 415-444-4860
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Fax | 415-444-4011
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY 23843
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License Number State | CA
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