Fogel, Travis

Fogel, Travis is an individual health care provider with primary practice located at 11406 Loma Linda Dr , Loma Linda CA 92354-3711. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Neuropsychologist, which is considered as his primary health care specialty. Fogel, Travis can be contacted via phone (909) 558-6144.

Contact Information

Primary practice address
11406 Loma Linda Dr Loma Linda CA 92354-3711
Phone: (909) 558-6144
Fax: (909) 558-3905
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X PSY17746 California

Profile Details

NPI number 1790718518
LBN Legal business name Fogel, Travis
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2006
Last updated Jul 8th, 2007 - about 19 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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Identifiers

StateTypeNumberIssuer
All States NPI 1790718518 NPPES
California MEDICAID PSY177460

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