MEDICARE: VICTORIA PICKERING PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	8060	CA

General Provider Information

NPI Number	:	1013063767
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA PICKERING PHD

Provider Business Mailing Address
First Line	:	601 COURT ST
Second Line	:	SUITE 206
City	:	JACKSON
State	:	CA
Zip	:	95642-2160
Country	:	US
Telephone Number	:	209-256-5602
Fax Number	:

Provider Business Practice Location Address
First Line	:	601 COURT ST
Second Line	:	SUITE 206
City	:	JACKSON
State	:	CA
Zip	:	95642-2160
Country	:	US
Telephone Number	:	209-256-5602
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2007
Last Update Date	:	09/27/2013

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Directions to “ VICTORIA PICKERING PHD” Practice Location

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