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NPI 1083906408 · live from the CMS NPI Registry

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Psychologist, Clinical in San Diego, CA. National Provider Identifier 1083906408, active.

NPI record

NPI1083906408 Type 2 · organization
StatusActive
Primary specialtyPsychologist, Clinical 103TC0700X
Practice location12625 High Bluff Dr Ste 104, San Diego, CA 92130
Practice phone858-208-9689
EnumeratedMay 3, 2011
Last updatedMay 3, 2011
Authorized officialCarrie Jaffe, Director/Owner

Taxonomies and licenses

TaxonomyCodeLicense
Psychologist, Clinical primary103TC0700XPSY18811 (CA)

Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.