Marcia M Asgarian, PHD
Individual provider Active NPI Psychologist · Lodi, CA
NPI 1063636645 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1063636645
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- 18390 (CA)
- Practice address
- 755 S Fairmont Ave Ste A3
Lodi, CA 95240-4643 - Phone
- (290) 327-5600
- Fax
- (209) 366-0277
- NPI assigned
- Apr 13, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 18390 | CA | Yes |
Addresses
Primary practice location
755 S Fairmont Ave Ste A3
Lodi, CA 95240-4643
Mailing address
755 S Fairmont Ave Ste A3
P.O. Box 2655
Lodi, CA 95240-4643
Phone (209) 327-5600
Other providers in Lodi, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.