Individual provider · Type 1 NPI

Ellen Marie Theobald, PhD

Clinical Psychologist · Riverside, CA

NPI number 1962576223 Active

Practice location

5015 Canyon Crest Dr, Suite 203
Riverside, CA 92507

Fax (951) 787-9093

Mailing address

5307 Stonewood Dr
Riverside, CA 92506

Specialties and licenses

TaxonomyCodeLicense
Clinical Psychologist Primary 103TC0700XPSY9953 (CA)

Clinical Psychologist: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of discip…

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About NPI 1962576223

Ellen Marie Theobald, PhD's National Provider Identifier is 1962576223, issued on Nov 20, 2006. The primary taxonomy on file is Clinical Psychologist (103TC0700X), and the practice location is in Riverside, CA. The record was last updated on Jul 8, 2007.