Provider Demographics
NPI:1720021975
Name:O'BRIEN, FLOYD JOSEPH (PHD)
Entity Type:Individual
Prefix:DR
First Name:FLOYD
Middle Name:JOSEPH
Last Name:O'BRIEN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 W ALDER ST
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95204-5701
Mailing Address - Country:US
Mailing Address - Phone:209-466-9159
Mailing Address - Fax:
Practice Address - Street 1:33 W ALDER ST
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95204-5701
Practice Address - Country:US
Practice Address - Phone:209-466-9159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY6749103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist