Provider Demographics
NPI:1801084561
Name:PFLAUMER, EDWARD B (PHD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:B
Last Name:PFLAUMER
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 1:721 NEVADA ST STE 203
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-8051
Mailing Address - Country:US
Mailing Address - Phone:909-798-5669
Mailing Address - Fax:909-335-9219
Practice Address - Street 1:721 NEVADA ST STE 203
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-8051
Practice Address - Country:US
Practice Address - Phone:909-798-5669
Practice Address - Fax:909-335-9219
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY10385103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGPS001160OtherMEDICAID-MEDI-CAL
CA0PL103850OtherMEDICARE PROVIDER
CA0PL103850OtherMEDICARE PTAN
CAPSY10385OtherCA LIC