Roth, William G

Roth, William G is an individual health care provider with primary practice located at 11374 Mountain View Ave Suite A, Loma Linda CA 92354-3830. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Roth, William G can be contacted via phone (909) 558-4505.

Contact Information

Primary practice address
11374 Mountain View Ave Suite A Loma Linda CA 92354-3830
Phone: (909) 558-4505
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X PSY10195 California

Profile Details

NPI number 1154346849
LBN Legal business name Roth, William G
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 13th, 2006
Last updated Sep 24th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154346849 NPPES
California MEDICAID PSY101950

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