Devereaux, Timothy Robert
Devereaux, Timothy Robert is an sole proprietor health care provider with primary practice located at 5905 Lake Earl Dr , Crescent City CA 95532-0001. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Devereaux, Timothy Robert can be contacted via phone (707) 465-1000.Contact Information
Primary practice address
5905 Lake Earl Dr
Crescent City CA 95532-0001
Phone: (707) 465-1000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | PSY32482 | California |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 529 | Wyoming |
Profile Details
| NPI number | 1497922967 |
|---|---|
| LBN Legal business name | Devereaux, Timothy Robert |
| Credentials | PSY.D |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 13th, 2008 |
| Last updated | Jul 13th, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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