| Rady Children's Hospital | |
|
3020 Childrens Way # Mc5081 San Diego CA 92123-4223 | |
| (858) 576-1700 | |
| (858) 966-8495 |
| Full Name | Rady Children's Hospital |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 3020 Childrens Way # Mc5081, San Diego, California |
| Authorized Official Name and Position | Christine Forest (CONTRACT SPECIALIST) |
| Authorized Official Contact | 8589667716 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rady Children's Hospital 3020 Childrens Way San Diego CA 92123-4223 Ph: (858) 576-1700 | Rady Children's Hospital 3020 Childrens Way # Mc5081 San Diego CA 92123-4223 Ph: (858) 576-1700 |
| NPI Number | 1629219845 |
|---|---|
| Provider Enumeration Date | 03/18/2009 |
| Last Update Date | 03/18/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629219845 | NPI | - | NPPES |
| ZZZH3702Z | Other | CA | BLUE SHIELD GROUP PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSY22035 (California) | Primary |
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