Provider Demographics
NPI:1457576563
Name:GLUHOVSKY, INNA MATOV (PSYD)
Entity Type:Individual
Prefix:DR
First Name:INNA
Middle Name:MATOV
Last Name:GLUHOVSKY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 HAMILTON AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94301-2030
Mailing Address - Country:US
Mailing Address - Phone:650-353-7498
Mailing Address - Fax:
Practice Address - Street 1:550 HAMILTON AVE STE 207
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-2030
Practice Address - Country:US
Practice Address - Phone:650-353-7498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 22643103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical