MEDICARE: DR. BARRY WILLIAM SLONE PH.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
1	103TC0700X	Clinical Psychologist	PSY8916	CA

General Provider Information

NPI Number	:	1831187285
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BARRY WILLIAM SLONE PH.D.

Provider Business Mailing Address
First Line	:	24502 PACIFIC PARK DR
Second Line	:	SUITE 101
City	:	ALISO VIEJO
State	:	CA
Zip	:	92656-3043
Country	:	US
Telephone Number	:	949-599-3044
Fax Number	:	949-643-9628

Provider Business Practice Location Address
First Line	:	24502 PACIFIC PARK DR
Second Line	:	SUITE 101
City	:	ALISO VIEJO
State	:	CA
Zip	:	92656-3043
Country	:	US
Telephone Number	:	949-599-3044
Fax Number	:	949-643-9628

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

Provider Enumeration Date	:	10/10/2005
Last Update Date	:	07/08/2007

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