Provider Demographics
NPI:1922571736
Name:ROY, PAUL J (LICENSED PSYCHOLOGIS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:J
Last Name:ROY
Suffix:
Gender:M
Credentials:LICENSED PSYCHOLOGIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2862 FORBES AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051-5667
Mailing Address - Country:US
Mailing Address - Phone:408-204-5552
Mailing Address - Fax:
Practice Address - Street 1:160 SARATOGA AVE STE 210
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-7334
Practice Address - Country:US
Practice Address - Phone:408-284-6604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-03
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY11265103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist