Charles N Harris PHD a Psychological Corp

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY3864 Issued in CA

Legal business name

CHARLES N HARRIS PHD A PSYCHOLOGICAL CORP

Practice address

4815 Thomas Rd
Sebastopol, CA 95472-9764

Phone

(707) 829-5170

NPI assigned

Dec 10, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Charles N Harris, PHD

Title

President

Phone

(707) 829-5170

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1197244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197244800000",
    "number": "1114100500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4815 THOMAS RD",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954729764",
            "telephone_number": "707-829-5170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4815 THOMAS RD",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954729764",
            "telephone_number": "707-829-5170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES N HARRIS PHD A PSYCHOLOGICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-10",
        "last_updated": "2007-12-10",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "707-829-5170",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY3864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Sebastopol, CA
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.