Provider Demographics
NPI:1124141619
Name:DANIEL S & RUTH D KALB
Entity type:Organization
Organization Name:DANIEL S & RUTH D KALB
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:D
Authorized Official - Last Name:KALB
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:707-745-8906
Mailing Address - Street 1:1021 1ST ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:BENICIA
Mailing Address - State:CA
Mailing Address - Zip Code:94510-3215
Mailing Address - Country:US
Mailing Address - Phone:707-745-8906
Mailing Address - Fax:
Practice Address - Street 1:1021 1ST ST
Practice Address - Street 2:SUITE 5
Practice Address - City:BENICIA
Practice Address - State:CA
Practice Address - Zip Code:94510-3215
Practice Address - Country:US
Practice Address - Phone:707-745-8906
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty