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NPI Code Detail

MEDICARE: TROY EWING PSY.D.

MEDICARE:   TROY  EWING  PSY.D.
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
1103T00000XPsychologistPSY20089CA

General Provider Information

NPI Number : 1104004571
Entity Type Code : Individual
Provider Name (Legal Business Name) : TROY EWING PSY.D.
Provider Business Mailing Address
First Line : 900 FULTON AVE
Second Line : SUITE 240
City : SACRAMENTO
State : CA
Zip : 95825-4500
Country : US
Telephone Number : 916-474-9337
Fax Number :
Provider Business Practice Location Address
First Line : 900 FULTON AVE
Second Line : SUITE 240
City : SACRAMENTO
State : CA
Zip : 95825-4500
Country : US
Telephone Number : 916-474-9337
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2008
Last Update Date : 03/06/2012

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