Provider Demographics
NPI:1952622250
Name:ORMOND, CHARLOTTE HELEN (PHD)
Entity type:Individual
Prefix:DR
First Name:CHARLOTTE
Middle Name:HELEN
Last Name:ORMOND
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2425 PARK BLVD # B102
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306-1931
Mailing Address - Country:US
Mailing Address - Phone:510-736-5115
Mailing Address - Fax:650-561-4752
Practice Address - Street 1:2425 PARK BLVD # B102
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-1931
Practice Address - Country:US
Practice Address - Phone:510-736-5115
Practice Address - Fax:650-561-4752
Is Sole Proprietor?:No
Enumeration Date:2010-06-21
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 22066103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical