Provider Demographics
NPI:1780017392
Name:STANLEY G EINHORN PHD
Entity Type:Organization
Organization Name:STANLEY G EINHORN PHD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:G
Authorized Official - Last Name:EINHORN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:831-359-5842
Mailing Address - Street 1:231 TREVETHAN AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062-1201
Mailing Address - Country:US
Mailing Address - Phone:831-359-5842
Mailing Address - Fax:831-359-5842
Practice Address - Street 1:6233 SOQUEL DR STE E
Practice Address - Street 2:
Practice Address - City:APTOS
Practice Address - State:CA
Practice Address - Zip Code:95003-3184
Practice Address - Country:US
Practice Address - Phone:831-359-5842
Practice Address - Fax:831-359-5842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-19
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY13906103TA0400X, 103TA0700X, 103TC0700X, 103TF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Multi-Specialty
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & AgingGroup - Multi-Specialty
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamilyGroup - Multi-Specialty